Maternal childhood adversity and prenatal depression: the protective role of father support

Exploring the Association Between Childhood Emotional Maltreatment and Eating Disorder Symptoms During Pregnancy: A Moderated Mediation Model with Prenatal Emotional Distress and Social Support

BACKGROUND/OBJECTIVES

Pregnancy is a critical period marked by significant transformations that can trigger or exacerbate eating disorder symptoms. Childhood emotional maltreatment, including abuse and neglect, is a known risk factor for disordered eating, yet its specific impact during pregnancy remains unexplored. For this reason, this study aimed to examine the link between childhood emotional maltreatment and eating disorder symptoms in pregnant women, also focusing on the potential mediating and moderating variables involved in this association. Specifically, this study explored the mediating role of prenatal emotional distress, whereas prenatal social support was investigated as a protective factor able to moderate the effects of past trauma on disordered eating during this sensitive period.

METHODS

Participants were 272 Italian pregnant women (aged 18-48, Mage = 31.21, SD = 4.95) who were asked to respond to four self-report instruments: Childhood Trauma Questionnaire-Short Form; Eating Disorder Examination-Questionnaire Short; Perinatal Assessment of Maternal Affectivity; and Maternity Social Support Scale.

RESULTS AND CONCLUSIONS

The results showed that prenatal emotional distress totally mediated the association between childhood emotional maltreatment and eating disorder symptoms in pregnant women (β = 0.20; SE = 0.06; 95% CI: 0.08, 0.33; p < 0.001). Moreover, moderation analysis showed that prenatal social support only moderated the direct link between childhood emotional maltreatment and disordered eating, so higher levels of childhood emotional maltreatment were predictive of higher levels of eating disorder symptoms only among pregnant women with low levels of prenatal social support (b = 0.17; SE = 0.06; t = 2.73; 95% CI: 0.05, 0.30; p < 0.01). The limitations and clinical implications are discussed.

Adverse Childhood Experiences and Perinatal Mental Health: A Review of Progress and Future Directions

PURPOSE OF REVIEW

This review includes recent literature on adverse childhood experiences (ACEs) and perinatal mental health. We summarize key findings, including meta-analytic reviews and emerging data on broad risks for psychopathology, mechanistic pathways, protective factors, and ACEs screening within clinical care contexts.

RECENT FINDINGS

ACEs are associated with small to moderate risks for perinatal depression and anxiety. There is increasing evidence ACEs are also associated with other mental health concerns and transdiagnostic symptoms during pregnancy and postpartum. Possible mechanistic factors include a range of biological and psychosocial variables. Unique effects of benevolent childhood experiences (BCEs) on perinatal mental health are also notable. Continued emphasis on associations between ACEs and perinatal mental health concerns beyond depression and anxiety is needed. More empirical attention to mechanistic and protective factors, including benevolent childhood experiences, is also warranted. Although ACEs screening in clinical settings may be feasible and acceptable, implementation should occur within a healing centered engagement framework.

The role of the hypothalamic-pituitary-adrenal axis in depression across the female reproductive lifecycle: current knowledge and future directions

The aim of this narrative review is to consolidate knowledge on the role of the hypothalamic-pituitary-adrenal (HPA) axis in depression pathophysiology at different reproductive stages across the female lifespan. Despite growing evidence about the impact of gonadal hormones on mood disorders, no previous review has examined the interaction between such hormonal changes and the HPA axis within the context of depressive disorders in women. We will focus on HPA axis function in depressive disorders at different reproductive stages including the menstrual cycle (e.g., premenstrual dysphoric disorder [PMDD]), perinatally (e.g., postpartum depression), and in perimenopausal depression. Each of these reproductive stages is characterized by vast physiological changes and presents major neuroendocrine reorganization. The HPA axis is one of the main targets of such functional alterations, and with its key role in stress response, it is an etiological factor in vulnerable windows for depression across the female lifespan. We begin with an overview of the HPA axis and a brief summary of techniques for measuring HPA axis parameters. We then describe the hormonal milieu of each of these key reproductive stages, and integrate information about HPA axis function in depression across these reproductive stages, describing similarities and differences. The role of a history of stress and trauma exposure as a contributor to female depression in the context of HPA axis involvement across the reproductive stages is also presented. This review advances the pursuit of understanding common biological mechanisms across depressive disorders among women. Our overarching goal is to identify unmet needs in characterizing stress-related markers of depression in women in the context of hormonal changes across the lifespan, and to support future research in women's mental health as it pertains to pathophysiology, early diagnosis, and treatment targets.