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The impact of maternal adverse childhood experiences and prenatal depressive symptoms on foetal attachment: Preliminary evidence from expectant mothers across eight middle-income countries

Year: 2021
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Mothers from middle-income countries (MIC) are estimated to have higher rates of adverse childhood experiences (ACEs) and depression during pregnancy compared to mothers from high income countries. Prenatal depression can adversely impact on a mother's feelings towards her foetus and thus may be partially responsible for intergenerational transmission of risk associated with maternal ACEs. However, the extent to which prenatal depressive symptoms mediate the association between maternal ACEs and foetal attachment is unknown. METHODS: Data on foetal attachment, ACEs, and prenatal depression came from mothers in their third trimester of pregnancy (n = 1,185) located across eight MICs, participating in the prospective birth cohort Evidence for Better Lives Study - Foundational Research (EBLS-FR). Data were from the baseline measurement. RESULTS: Full-sample path mediation analyses, adjusting for relevant covariates, suggested a full mediating effect of prenatal depression. However, at the individual-country level, both positive and negative effects of ACEs on foetal attachment were observed after the inclusion of depressive symptoms as a mediator, suggesting cultural and geographical factors may influence a mother's empathic development after ACE exposure. LIMITATIONS: As no follow-up measurements of depressive symptoms or postnatal attachment were included in the analyses, the findings cannot be extrapolated to the postnatal period and beyond. Further, causality cannot be inferred as the study was observational. CONCLUSIONS: The findings reinforce the importance of screening for prenatal depression during antenatal care in MICs. Addressing prenatal depression within maternal health care may support foetal attachment and contribute to reducing the intergenerational transmission of disadvantage.
DOI: 10.1016/j.jad.2021.08.066
Authors: Ruth Harriet Brown, Manuel Eisner, Susan Walker, Mark Tomlinson, Pasco Fearon, Michael P Dunne, Sara Valdebenito, Claire Hughes, Catherine L. Ward, Siham Sikander, Joseph Osafo, Bernadette Madrid, Adriana Baban, Vo Van Thang, Asvini D. Fernando, Aja L Murray
Institutions: University of Edinburgh, University of Zurich, University of Cambridge, University of the West Indies System, University of the West Indies, Queen's University Belfast, Stellenbosch University, University College London, Queensland University of Technology, University of Cape Town, Health Services Academy, University of Ghana, University of the Philippines Manila, Babeș-Bolyai University, Hue University, Huế University of Medicine and Pharmacy, University of Kelaniya
Language: English
Field: Medicine
Open Access status: green
Funders: British Academy, Queensland University of Technology, Jacobs Foundation, UBS Optimus Foundation, Fondation Botnar, Economic and Social Research Council
OpenAlex ID: W3164180238
FWCI: 3.892
Cites: 72
Cited by: 28
Related to: 10