“Echoes of a dark past” is a history of maternal childhood maltreatment a perinatal risk factor for pregnancy and postpartum trauma experiences? A longitudinal study
Abstract Background Although associations between maternal exposure to adverse childhood experiences (ACEs) and perinatal anxiety and depression are established, there is a paucity of information about the associations between ACEs and perinatal trauma and perinatal post-traumatic stress outcomes. F...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-05-01
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| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12884-023-05714-2 |
| _version_ | 1797811297466712064 |
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| author | Tracey Mackle Lucía Colodro-Conde Therese de Dassel Anastasia Braun Adele Pope Elizabeth Bennett Alka Kothari George Bruxner Sarah E. Medland Sue Patterson |
| author_facet | Tracey Mackle Lucía Colodro-Conde Therese de Dassel Anastasia Braun Adele Pope Elizabeth Bennett Alka Kothari George Bruxner Sarah E. Medland Sue Patterson |
| author_sort | Tracey Mackle |
| collection | DOAJ |
| description | Abstract Background Although associations between maternal exposure to adverse childhood experiences (ACEs) and perinatal anxiety and depression are established, there is a paucity of information about the associations between ACEs and perinatal trauma and perinatal post-traumatic stress outcomes. For the purposes of this article, perinatal trauma is defined as a very frightening or distressing event that may result in psychological harm. The event must have been related to conception, pregnancy, birth, and up to 12 months postpartum. Methods Women recruited at an antenatal appointment (n = 262) were invited to complete online surveys at two-time points; mid-pregnancy and eight weeks after the estimated date of delivery. The ACE Q 10-item self-reporting tool and a perinatal trauma screen related to the current and/or a previous perinatal period were completed. If the perinatal trauma screen was positive at either time point in the study, women were invited to complete a questionnaire examining symptoms of perinatal post-traumatic stress disorder and, if consenting, a clinical interview where the Post-traumatic Symptoms Scale was administered. Results Sixty women (22.9%) reported four or more ACEs. These women were almost four times more likely to endorse perinatal trauma, when compared with those who either did not report ACEs (OR = 3.6, CI 95% 1.74 – 7.36, p < 0.001) or had less than four ACEs (OR = 3.9, CI 95% 2.037.55, p < 0.001). A 6–sevenfold increase in perinatal trauma was seen amongst women who reported having at least one ACE related to abuse (OR = 6.23, CI 95% 3.32–11.63, p < 0.001) or neglect (OR = 6.94, CI 95% 2.95–16.33, p < 0.001). The severity of perinatal-PTSD symptoms for those with perinatal trauma in pregnancy was significantly higher in those women exposed to at least one ACE related to abuse. Conclusions Awareness of maternal exposure to childhood adversity/maltreatment is critical to providing trauma-informed approaches in the perinatal setting. Our study suggests that routine screening for ACEs in pregnancy adds clinical value. This adds to previous research confirming the relationship between ACEs and mental health complexities and suggests that ACEs influence perinatal mental health outcomes. |
| first_indexed | 2024-03-13T07:20:34Z |
| format | Article |
| id | doaj.art-d208964eb4374c649c5a823e1e9d4b37 |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-03-13T07:20:34Z |
| publishDate | 2023-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-d208964eb4374c649c5a823e1e9d4b372023-06-04T11:41:34ZengBMCBMC Pregnancy and Childbirth1471-23932023-05-0123111210.1186/s12884-023-05714-2“Echoes of a dark past” is a history of maternal childhood maltreatment a perinatal risk factor for pregnancy and postpartum trauma experiences? A longitudinal studyTracey Mackle0Lucía Colodro-Conde1Therese de Dassel2Anastasia Braun3Adele Pope4Elizabeth Bennett5Alka Kothari6George Bruxner7Sarah E. Medland8Sue Patterson9Metro North Mental Health Service, Perinatal Wellbeing Team BrisbaneQIMR Berghofer Medical Research InstituteMetro North Mental Health Service, Perinatal Wellbeing Team BrisbaneMetro North Mental Health Service, Perinatal Wellbeing Team BrisbaneMetro North Mental Health Service, Perinatal Wellbeing Team BrisbaneMetro North Mental Health Service, Perinatal Wellbeing Team BrisbaneUniversity of QueenslandRedcliffe HospitalQIMR Berghofer Medical Research InstituteUniversity of QueenslandAbstract Background Although associations between maternal exposure to adverse childhood experiences (ACEs) and perinatal anxiety and depression are established, there is a paucity of information about the associations between ACEs and perinatal trauma and perinatal post-traumatic stress outcomes. For the purposes of this article, perinatal trauma is defined as a very frightening or distressing event that may result in psychological harm. The event must have been related to conception, pregnancy, birth, and up to 12 months postpartum. Methods Women recruited at an antenatal appointment (n = 262) were invited to complete online surveys at two-time points; mid-pregnancy and eight weeks after the estimated date of delivery. The ACE Q 10-item self-reporting tool and a perinatal trauma screen related to the current and/or a previous perinatal period were completed. If the perinatal trauma screen was positive at either time point in the study, women were invited to complete a questionnaire examining symptoms of perinatal post-traumatic stress disorder and, if consenting, a clinical interview where the Post-traumatic Symptoms Scale was administered. Results Sixty women (22.9%) reported four or more ACEs. These women were almost four times more likely to endorse perinatal trauma, when compared with those who either did not report ACEs (OR = 3.6, CI 95% 1.74 – 7.36, p < 0.001) or had less than four ACEs (OR = 3.9, CI 95% 2.037.55, p < 0.001). A 6–sevenfold increase in perinatal trauma was seen amongst women who reported having at least one ACE related to abuse (OR = 6.23, CI 95% 3.32–11.63, p < 0.001) or neglect (OR = 6.94, CI 95% 2.95–16.33, p < 0.001). The severity of perinatal-PTSD symptoms for those with perinatal trauma in pregnancy was significantly higher in those women exposed to at least one ACE related to abuse. Conclusions Awareness of maternal exposure to childhood adversity/maltreatment is critical to providing trauma-informed approaches in the perinatal setting. Our study suggests that routine screening for ACEs in pregnancy adds clinical value. This adds to previous research confirming the relationship between ACEs and mental health complexities and suggests that ACEs influence perinatal mental health outcomes.https://doi.org/10.1186/s12884-023-05714-2Adverse childhood experiencesPregnancyPostpartumPerinatal outcomesPost-traumatic stress disorderTrauma |
| spellingShingle | Tracey Mackle Lucía Colodro-Conde Therese de Dassel Anastasia Braun Adele Pope Elizabeth Bennett Alka Kothari George Bruxner Sarah E. Medland Sue Patterson “Echoes of a dark past” is a history of maternal childhood maltreatment a perinatal risk factor for pregnancy and postpartum trauma experiences? A longitudinal study BMC Pregnancy and Childbirth Adverse childhood experiences Pregnancy Postpartum Perinatal outcomes Post-traumatic stress disorder Trauma |
| title | “Echoes of a dark past” is a history of maternal childhood maltreatment a perinatal risk factor for pregnancy and postpartum trauma experiences? A longitudinal study |
| title_full | “Echoes of a dark past” is a history of maternal childhood maltreatment a perinatal risk factor for pregnancy and postpartum trauma experiences? A longitudinal study |
| title_fullStr | “Echoes of a dark past” is a history of maternal childhood maltreatment a perinatal risk factor for pregnancy and postpartum trauma experiences? A longitudinal study |
| title_full_unstemmed | “Echoes of a dark past” is a history of maternal childhood maltreatment a perinatal risk factor for pregnancy and postpartum trauma experiences? A longitudinal study |
| title_short | “Echoes of a dark past” is a history of maternal childhood maltreatment a perinatal risk factor for pregnancy and postpartum trauma experiences? A longitudinal study |
| title_sort | echoes of a dark past is a history of maternal childhood maltreatment a perinatal risk factor for pregnancy and postpartum trauma experiences a longitudinal study |
| topic | Adverse childhood experiences Pregnancy Postpartum Perinatal outcomes Post-traumatic stress disorder Trauma |
| url | https://doi.org/10.1186/s12884-023-05714-2 |
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