Combinations of Adverse Childhood Events and Risk of Postpartum Depression Among Mothers Enrolled in a Home Visiting Program.

Abstract Purpose The purpose of this study was to examine how combinations of adverse childhood events (ACEs) contribute to the risk of postpartum depression and the mediating role of prenatal social support. Methods The Adverse Childhood Experiences Scale Questionnaire and Edinburgh Postnatal Depression Scale Questionnaire were used to measure the study’s exposure and outcome. Among a cohort of 419 mothers enrolled in a home visiting program, latent class analyses were used to identify classes of ACEs exposure. General linear models assessed the risk of postpartum depression; prenatal social support was examined as a mediator. Results Four distinct classes of ACEs exposure were identified. On the Edinburgh Postnatal Depression scale, mothers who were classified in Classes 1-3 scored higher by 2.6-4.4 points compared to women in class 0. ACE class was found to be indirectly associated with postpartum depression scores through prenatal social support. Conclusions Identifying combinations of ACEs in a HV program has the potential to improve characterization of ACEs among low-income perinatal women in the United States. Elucidating how these combinations contribute to the risk of postpartum depression has the potential to identify women at increased risk which can help HV programs prioritize prevention efforts.