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



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.


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



Postpartum depression


Adverse childhood experiences


Intimate partner violence


Edinburgh Postnatal Depression Scale



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.


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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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