Adverse Childhood Experiences (ACEs) and childbearing and perinatal mental health outcomes in a clinical sample of women.

Abstract

Adverse Childhood Experiences (ACE) are associated with later life complications, including childbearing outcomes and episodes of mental ill-health. The perinatal period is a timepoint of vulnerability to the impacts of early life adversity, such as ACEs. We explored the association between maternal exposure to ACEs, entering parenthood, and episodes of mental ill-health during the perinatal period in a clinical sample with a mental health diagnosis to determine the increased vulnerability the perinatal period brings. Participants (N = 1494) were recruited across the UK, were aged 18 years or over, and female. Standardised self-report questionnaires ascertained demographic, parenthood, mental health, and ACE related information. Within this clinical sample, (N = 1010) women had given birth, and episodes of perinatal mental ill-health were assessed. Maternal childhood physical abuse was associated with an increased likelihood of having children, yet having divorced parents reduced this likelihood. In a clinical sub-sample of women who had children, physical abuse predicted a perinatal episode of bipolar disorder, sexual abuse a perinatal episode of anxiety disorders, and emotional neglect a perinatal episode of depressive disorders. CONCLUSIONS: Specific ACE exposure is associated with entering parenthood and episodes of mental ill-health during the perinatal period. This highlights a moment in the human lifespan when women who have experienced early adversity may be particularly vulnerable; the findings therefore have potential implications for the resourcing of specialist clinical services.