Adverse Childhood Experiences and Mental and Behavioral Health Conditions During Pregnancy: The Role of Resilience

被引:72
|
作者
Young-Wolff, Kelly C. [1 ]
Alabaster, Amy [1 ]
Mccaw, Brigid [2 ]
Stoller, Nicole [1 ]
Watson, Carey [3 ]
Sterling, Stacy [1 ]
Ridout, Kathryn K. [4 ]
Flanagan, Tracy [5 ]
机构
[1] Kaiser Permanente Northern Calif, Div Res, 2000 Broadway, Oakland, CA 94612 USA
[2] Kaiser Permanente Northern Calif, Family Violence Prevent Program, Oakland, CA USA
[3] Kaiser Antioch Med Ctr, Obstet & Gynecol, Antioch, CA USA
[4] Kaiser Permanente San Jose, Dept Psychiat, San Jose, CA USA
[5] Kaiser Permanente Northern Calif, Reg Off, Permanente Med Grp, Oakland, CA USA
关键词
adverse childhood experiences; mental health; pregnancy; intimate partner violence; resilience; INTIMATE PARTNER VIOLENCE; LOW-BIRTH-WEIGHT; ILLICIT DRUG-USE; INTERGENERATIONAL TRANSMISSION; REPRESENTATIVE SAMPLE; HOUSEHOLD DYSFUNCTION; MATERNAL ANXIETY; FAMILY VIOLENCE; ABUSE; DEPRESSION;
D O I
10.1089/jwh.2018.7108
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Introduction: Little is known about how exposure to adverse childhood experiences (ACEs) and protective factors, such as resilience, influence prenatal mental and behavioral health. This study examined associations between exposure to ACEs and mental and behavioral health during pregnancy overall and among women with high versus low levels of resilience. Materials and Methods: Women in two Kaiser Permanente Northern California medical centers were screened for ACEs and resilience during prenatal care (similar to 14-23 weeks of gestation; N = 355). Multivariable logistic regression analyses examined associations between ACEs and prenatal mental and behavioral health conditions overall and for women with low (<= 32) versus high (>32) resilience on the 10-item Connor-Davidson Resilience Scale. Results: Overall, 54% of women reported 0 ACEs, 28% 1-2 ACEs, and 18% 3+ ACEs. Relative to women with 0 ACEs, those with 1-2 ACEs had higher odds of an anxiety or depressive disorder and intimate partner violence (IPV) (odds ratios [ORs] 2.42-3.12, p < 0.05), and those with 3+ ACEs had higher odds of an anxiety or depressive disorder, depression symptoms, and IPV (ORs 3.08-4.71, p < 0.05). In stratified analyses by high (56%) and low (44%) resilience, having one or more ACEs (vs. 0 ACEs) was only associated with worse mental and behavioral health in women with low resilience. Conclusions: ACEs predicted mental and behavioral health conditions among pregnant women, and associations were the strongest among women with low levels of current resilience. Longitudinal research is needed to understand the causal mechanisms underlying these associations.
引用
收藏
页码:452 / 461
页数:10
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