A role for adverse childhood experiences and depression in preeclampsia

• Published in: Journal of clinical and translational science Vol. 8; no. 1; p. e25
• Main Authors: Myers, Monica, Gumusoglu, Serena, Brandt, Debra, Stroud, Amy, Hunter, Stephen K, Vignato, Julie, Nuckols, Virginia, Pierce, Gary L, Santillan, Mark K, Santillan, Donna A
• Format: Journal Article
• Language: English
• Published: England Cambridge University Press 2024
• Subjects: Adverse childhood experiences; Blood pressure; Body mass index; Cardiovascular disease; Children; Demographics; depression; Emotional disorders; Ethnicity; Hispanic Americans; Hypertension; Imprisonment; Medical records; Mental depression; Mood disorders; Morbidity; Mortality; neglect; Obstetrics; Postpartum depression; Pre-eclampsia; Preeclampsia; Pregnancy; Pregnancy complications; Questionnaires; Risk factors; trauma; United States > US; trauma; depression; Preeclampsia; adverse childhood experiences; neglect
• DOI: 10.1017/cts.2023.704
• ISSN: 2059-8661

Adverse childhood experiences (ACEs) are a measure of childhood adversity and are associated with life-long morbidity. The impacts of ACEs on peripartum health including preeclampsia, a common and dangerous hypertensive disorder of pregnancy, remain unclear, however. Therefore, we aimed to determine ACE association with peripartum psychiatric health and prevalence of preeclampsia using a case-control design. Clinical data were aggregated and validated using a large, intergenerational knowledgebase developed at our institution. Depression symptoms were measured by standard clinical screeners: the Patient Health Questionnaire-9 (PHQ-9) and the Edinburgh Postnatal Depression Scale (EPDS). ACEs were assessed via survey. Scores were compared between participants with ( = 32) and without ( = 46) prior preeclampsia. Participants with ACE scores ≥4 had significantly greater odds of preeclampsia than those with scores ≤ 3 (adjusted odds ratio = 6.71, 95% confidence interval:1.13-40.00; = 0.037). Subsequent speculative analyses revealed that increased odds of preeclampsia may be driven by increased childhood abuse and neglect dimensions of the ACE score. PHQ-9 scores (3.73 vs. 1.86, = 0.03), EPDS scores (6.38 vs. 3.71, = 0.01), and the incidence of depression (37.5% vs. 23.9%, = 0.05) were significantly higher in participants with a history of preeclampsia versus controls. Childhood sets the stage for life-long health. Our findings suggest that ACEs may be a risk factor for preeclampsia and depression, uniting the developmental origins of psychiatric and obstetric risk.