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Maternal and Child Health Journal

, Volume 22, Issue 7, pp 1051–1058 | Cite as

Adverse Childhood Experiences and Postpartum Depression in Home Visiting Programs: Prevalence, Association, and Mediating Mechanisms

Article

Abstract

Objectives In this study, we examined the prevalence of postpartum depression (PPD) and its association with select demographic factors and antenatal conditions. We also investigated whether greater exposure to adverse childhood experiences (ACEs) is associated with PPD, and if antenatal conditions mediate the ACE-PPD relationship. Methods Data were collected from 735 low-income women receiving home visiting services. Descriptive and bivariate analyses provided estimates of PPD and its correlates, and nested path analyses were used to test for mediation. Results We found that rates of PPD were high compared to prevalence estimates in the general population. Sample rates of antenatal depression were even higher than the rates of PPD. Omnibus tests revealed that PPD did not vary significantly by maternal age or race/ethnicity, although Hispanic women consistently reported the lowest rates. American Indian women and non-Hispanic white women reported the highest rates. PPD was significantly associated with increased exposure to ACEs. Nested path models revealed that the effects of ACEs were partially mediated by three antenatal conditions: intimate partner violence (IPV), perceived stress, and antenatal depression. Conclusions for Practice Supporting prior research, rates of PPD appear to be high among low-income women. ACEs may increase the risk of antenatal IPV and psychological distress, both of which may contribute to PPD. The findings have implications for screening and assessment as well as the timing and tailoring of interventions through home visiting and other community-based services.

Keywords

Postpartum depression Antenatal depression Adverse childhood experiences Intimate partner violence Perceived stress Home visiting 

Abbreviations

PPD

Postpartum depression

ACEs

Adverse childhood experiences

IPV

Intimate partner violence

EPDS

Edinburgh Postnatal Depression Scale

Notes

Acknowledgements

Support for this research was provided by the U.S. Department of Health and Human Services, Health Resources and Services Administration (Awards 1 D89MC28259-01-00 and 1 D89MC26367-01-00). The authors would like to thank the Wisconsin Department of Children and Families and the Wisconsin Department of Health Services for assistance with the collection, storage, and sharing of study data.

References

  1. Ammerman, R. T., Putnam, F. W., Altaye, M., Chen, L., Holleb, L. J., Stevens, J., … Van Ginkel, J. B. (2009). Changes in depressive symptoms in first time mothers in home visitation. Child Abuse & Neglect, 33(3), 127–138.CrossRefGoogle Scholar
  2. Ammerman, R. T., Putnam, F. W., Bosse, N. R., Teeters, A. R., & Van Ginkel, J. B. (2010). Maternal depression in home visitation: A systematic review. Aggression and Violent Behavior, 15(3), 191–200.CrossRefPubMedPubMedCentralGoogle Scholar
  3. Asparouhov, T., & Muthén, B. (2010). Weighted least squares estimation with missing data. Mplus Technical Appendix, 2010, 1–10.Google Scholar
  4. Baker, L., Cross, S., Greaver, L., Wei, G., Lewis, R., & CORPS, H. S (2005). Prevalence of postpartum depression in a Native American population. Maternal and Child Health Journal, 9(1), 21–25.CrossRefPubMedGoogle Scholar
  5. Banti, S., Mauri, M., Oppo, A., Borri, C., Rambelli, C., Ramacciotti, D., … Cassano, G. B. (2011). From the third month of pregnancy to 1 year postpartum. Prevalence, incidence, recurrence, and new onset of depression. Results from the Perinatal Depression-Research & Screening Unit study. Comprehensive Psychiatry, 52(4), 343–351.CrossRefPubMedGoogle Scholar
  6. Beck, C. T. (2001). Predictors of postpartum depression: An update. Nursing Research, 50(5), 275–285.CrossRefPubMedGoogle Scholar
  7. Bennett, H. A., Einarson, A., Taddio, A., Koren, G., & Einarson, T. R. (2004). Prevalence of depression during pregnancy: Systematic review. Obstetrics & Gynecology, 103(4), 698–709.CrossRefGoogle Scholar
  8. Bergink, V., Kooistra, L., Lambregtse-van den Berg, M. P., Wijnen, H., Bunevicius, R., van Baar, A., & Pop, V. (2011). Validation of the Edinburgh Depression Scale during pregnancy. Journal of Psychosomatic Research, 70(4), 385–389.CrossRefPubMedGoogle Scholar
  9. Beydoun, H. A., Beydoun, M. A., Kaufman, J. S., Lo, B., & Zonderman, A. B. (2012). Intimate partner violence against adult women and its association with major depressive disorder, depressive symptoms and postpartum depression: A systematic review and meta-analysis. Social Science & Medicine, 75(6), 959–975.CrossRefGoogle Scholar
  10. Burke, N. J., Hellman, J. L., Scott, B. G., Weems, C. F., & Carrion, V. G. (2011). The impact of adverse childhood experiences on an urban pediatric population. Child Abuse & Neglect, 35(6), 408–413.CrossRefGoogle Scholar
  11. Chapman, D. P., Whitfield, C. L., Felitti, V. J., Dube, S. R., Edwards, V. J., & Anda, R. F. (2004). Adverse childhood experiences and the risk of depressive disorders in adulthood. Journal of Affective Disorders, 82(2), 217–225.CrossRefPubMedGoogle Scholar
  12. Chung, E. K., Mathew, L., Elo, I. T., Coyne, J. C., & Culhane, J. F. (2008). Depressive symptoms in disadvantaged women receiving prenatal care: The influence of adverse and positive childhood experiences. Ambulatory Pediatrics, 8(2), 109–116.CrossRefPubMedGoogle Scholar
  13. Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24(4), 385–396.CrossRefPubMedGoogle Scholar
  14. Cox, J. L., Holden, J. M., & Sagovsky, R. (1987). Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. The British Journal of Psychiatry, 150(6), 782–786.CrossRefPubMedGoogle Scholar
  15. Deal, L. W., & Holt, V. L. (1998). Young maternal age and depressive symptoms: Results from the 1988 National Maternal and Infant Health Survey. American Journal of Public Health, 88(2), 266–270.CrossRefPubMedPubMedCentralGoogle Scholar
  16. Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., … Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) Study. American Journal of Preventive Medicine, 14(4), 245–258.CrossRefPubMedGoogle Scholar
  17. Field, T. (2010). Postpartum depression effects on early interactions, parenting, and safety practices: A review. Infant Behavior and Development, 33(1), 1–6.CrossRefPubMedGoogle Scholar
  18. Gavin, N. I., Gaynes, B. N., Lohr, K. N., Meltzer-Brody, S., Gartlehner, G., & Swinson, T. (2005). Perinatal depression: A systematic review of prevalence and incidence. Obstetrics and Gynecology, 106(5 Pt 1), 1071–1083.CrossRefPubMedGoogle Scholar
  19. Gjerdingen, D. K., & Yawn, B. P. (2007). Postpartum depression screening: Importance, methods, barriers, and recommendations for practice. The Journal of the American Board of Family Medicine, 20(3), 280–288.CrossRefPubMedGoogle Scholar
  20. Gone, J. P., & Trimble, J. E. (2012). American Indian and Alaska Native mental health: Diverse perspectives on enduring disparities. Annual Review of Clinical Psychology, 8, 131–160.CrossRefPubMedGoogle Scholar
  21. Goodson, B. D., Mackrain, M., Perry, D. F., O’Brien, K., & Gwaltney, M. K. (2013). Enhancing home visiting with mental health consultation. Pediatrics, 132(Supplement 2), S180–S190.CrossRefPubMedGoogle Scholar
  22. Grace, S. L., Evindar, A., & Stewart, D. E. (2003). The effect of postpartum depression on child cognitive development and behavior: A review and critical analysis of the literature. Archives of Women’s Mental Health, 6(4), 263–274.CrossRefPubMedGoogle Scholar
  23. Green, J. G., McLaughlin, K. A., Berglund, P. A., Gruber, M. J., Sampson, N. A., Zaslavsky, A. M., & Kessler, R. C. (2010). Childhood adversities and adult psychiatric disorders in the national comorbidity survey replication I: Associations with first onset of DSM-IV disorders. Archives of General Psychiatry, 67(2), 113–123.CrossRefPubMedPubMedCentralGoogle Scholar
  24. Hasin, D. S., Goodwin, R. D., Stinson, F. S., & Grant, B. F. (2005). Epidemiology of major depressive disorder: Results from the National Epidemiologic Survey on Alcoholism and Related Conditions. Archives of General Psychiatry, 62(10), 1097–1106.CrossRefPubMedGoogle Scholar
  25. Hobfoll, S. E., Ritter, C., Lavin, J., Hulsizer, M. R., & Cameron, R. P. (1995). Depression prevalence and incidence among inner-city pregnant and postpartum women. Journal of Consulting and Clinical Psychology, 63(3), 445–453.CrossRefPubMedGoogle Scholar
  26. Howell, E. A., Mora, P. A., Horowitz, C. R., & Leventhal, H. (2005). Racial and ethnic differences in factors associated with early postpartum depressive symptoms. Obstetrics and Gynecology, 105(6), 1442–1450.CrossRefPubMedPubMedCentralGoogle Scholar
  27. Lancaster, C. A., Gold, K. J., Flynn, H. A., Yoo, H., Marcus, S. M., & Davis, M. M. (2010). Risk factors for depressive symptoms during pregnancy: A systematic review. American Journal of Obstetrics and Gynecology, 202(1), 5–14.CrossRefPubMedPubMedCentralGoogle Scholar
  28. LaNoue, M., Graeber, D., de Hernandez, B. U., Warner, T. D., & Helitzer, D. L. (2012). Direct and indirect effects of childhood adversity on adult depression. Community Mental Health Journal, 48(2), 187–192.CrossRefPubMedGoogle Scholar
  29. Lee, E. H. (2012). Review of the psychometric evidence of the perceived stress scale. Asian Nursing Research, 6(4), 121–127.CrossRefPubMedGoogle Scholar
  30. Lee, E. J., & Park, J. S. (2015). Development of a prediction model for postpartum depression: Based on the mediation effect of antepartum depression. Journal of Korean Academy of Nursing, 45(2), 211–220.CrossRefPubMedGoogle Scholar
  31. Luke, S., Salihu, H. M., Alio, A. P., Mbah, A. K., Jeffers, D., Berry, E. L., & Mishkit, V. R. (2009). Risk factors for major antenatal depression among low-income African American women. Journal of Women’s Health, 18(11), 1841–1846.CrossRefPubMedGoogle Scholar
  32. McEwen, B. S. (1999). Stress and hippocampal plasticity. Annual Review of Neuroscience, 22(1), 105–122.CrossRefPubMedGoogle Scholar
  33. Mersky, J. P., Topitzes, J., & Reynolds, A. J. (2013). Impacts of adverse childhood experiences on health, mental health, and substance use in early adulthood: A cohort study of an urban, minority sample in the US. Child Abuse & Neglect, 37(11), 917–925.CrossRefGoogle Scholar
  34. Murray, D., & Cox, J. (1990). Screening for depression during pregnancy with the Edinburgh Postnatal Depression Scale (EPDS). Journal of Reproductive and Infant Psychology, 8(2), 99–107.CrossRefGoogle Scholar
  35. Muthén, L. K., & Muthén, B. O. (1998–2012). Mplus user’s guide (7th ed.). Los Angeles, CA: Muthén & Muthén.Google Scholar
  36. O’Hara, M. W., & Swain, A. M. (1996). Rates and risk of postpartum depression—A meta-analysis. International Review of Psychiatry, 8(1), 37–54.CrossRefGoogle Scholar
  37. Rabin, R. F., Jennings, J. M., Campbell, J. C., & Bair-Merritt, M. H. (2009). Intimate partner violence screening tools: A systematic review. American Journal of Preventive Medicine, 36(5), 439–445.CrossRefPubMedPubMedCentralGoogle Scholar
  38. Riolo, S. A., Nguyen, T. A., Greden, J. F., & King, C. A. (2005). Prevalence of depression by race/ethnicity: Findings from the National Health and Nutrition Examination Survey III. American Journal of Public Health, 95(6), 998–1000.CrossRefPubMedPubMedCentralGoogle Scholar
  39. Robertson, E., Grace, S., Wallington, T., & Stewart, D. E. (2004). Antenatal risk factors for postpartum depression: A synthesis of recent literature. General Hospital Psychiatry, 26(4), 289–295.CrossRefPubMedGoogle Scholar
  40. Rudolph, K. D., Flynn, M., Abaied, J. L., Groot, A., & Thompson, R. (2009). Why is past depression the best predictor of future depression? Stress generation as a mechanism of depression continuity in girls. Journal of Clinical Child & Adolescent Psychology, 38(4), 473–485.CrossRefGoogle Scholar
  41. Rudolph, K. D., Hammen, C., Burge, D., Lindberg, N., Herzberg, D., & Daley, S. E. (2000). Toward an interpersonal life-stress model of depression: The developmental context of stress generation. Development and Psychopathology, 12(02), 215–234.CrossRefPubMedGoogle Scholar
  42. Segre, L. S., O’Hara, M. W., Arndt, S., & Stuart, S. (2007). The prevalence of postpartum depression. Social Psychiatry and Psychiatric Epidemiology, 42(4), 316–321.CrossRefPubMedGoogle Scholar
  43. Soeken, K. L., McFarlane, J., Parker, B., & Lominack, M. C. (1998). The abuse assessment screen: A clinical instrument to measure frequency, severity, and perpetrator of abuse against women. Sage Series on Violence Against Women, 10, 195–203.Google Scholar
  44. Thombs, B. D., Arthurs, E., Coronado-Montoya, S., Roseman, M., Delisle, V. C., Leavens, A., … Zelkowitz, P. (2014). Depression screening and patient outcomes in pregnancy or postpartum: A systematic review. Journal of Psychosomatic Research, 76(6), 433–446.CrossRefPubMedGoogle Scholar
  45. Wisner, K. L., Chambers, C., & Sit, D. K. (2006). Postpartum depression: A major public health problem. JAMA, 296(21), 2616–2618.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Helen Bader School of Social WelfareUniversity of Wisconsin-MilwaukeeMilwaukeeUSA

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