The impact of maternal adverse childhood experiences and prenatal depressive symptoms on foetal attachment: Preliminary evidence from expectant mothers across eight middle-income countries
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Date
2021
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Journal of Affective Disorders
Abstract
Background: Mothers from middle-income countries (MIC) are estimated to have higher rates of adverse child hood 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.
Description
Research Article
Keywords
Adverse childhood experiences, Maternal-foetal-attachment, Depressive symptoms