The relationship between childhood trauma, socioeconomic status, and maternal depression among pregnant women in a South African birth cohort study

Tatini Mal-Sarkar; Katherine Keyes; Nastassja Koen; Whitney Barnett; Landon Myer; Caroline Rutherford; Heather J. Zar; Dan J. Stein; Crick Lund

doi:10.1016/j.ssmph.2021.100770

The relationship between childhood trauma, socioeconomic status, and maternal depression among pregnant women in a South African birth cohort study

Tatini Mal-Sarkar^*, Katherine Keyes, Nastassja Koen, Whitney Barnett, Landon Myer, Caroline Rutherford, Heather J. Zar, Dan J. Stein, Crick Lund

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

8 Citations (Scopus)

Abstract

Background: Maternal depression is an important cause of morbidity and mortality. Experiences of childhood trauma contribute to maternal depression, potentially causing adult socio-economic disparities in mental health. We investigate whether adult socioeconomic status (SES) mediates the relationship between childhood trauma and antenatal depression. Methods: We analyzed data from two sociodemographically distinct peri-urban sites in the Western Cape, South Africa in a birth cohort study, the Drakenstein Child Health Study: Mbekweni (N = 510) and TC Newman (N = 413). Data were collected from pregnant women between 28 and 32 weeks’ gestation. Results: Associations between trauma and depressive symptoms differed by site (χ²=2163.6, df = 1419, p < 0.01); direct effects of trauma on depression were 0.24 mean increased symptoms in Mbekweni (p < 0.01) and 0.47 in TC Newman (p < 0.01). Trauma was differentially associated with SES (Mbekweni: −0.10, p = 0.07; TC Newman: −0.05, p = 0.37) and SES with depression (Mbekweni: −0.18, p < 0.01; TC Newman: −0.02, p = 0.62) across both sites. Indirect effects of trauma on depression through SES were 0.018 (95% C.I. −0.002-0.039) in Mbekweni and 0.001 (95% C.I. −0.004-0.006) in TC Newman, suggesting mediation was not supported. SES was a stronger indicator of depression risk in relatively poorer Mbekweni. Conclusion: Neighborhood-level effects and poverty are potentially important modifiers, and points of intervention, for maternal mental health outcomes.

Original language	English
Article number	100770
Journal	SSM - Population Health
Volume	14
DOIs	https://doi.org/10.1016/j.ssmph.2021.100770
Publication status	Published - Jun 2021

Keywords

Birth cohort
Depression
Epidemiology
Poverty
Trauma

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.ssmph.2021.100770

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@article{5bafbae3198749e19fbbc0f4d6e8c978,

title = "The relationship between childhood trauma, socioeconomic status, and maternal depression among pregnant women in a South African birth cohort study",

abstract = "Background: Maternal depression is an important cause of morbidity and mortality. Experiences of childhood trauma contribute to maternal depression, potentially causing adult socio-economic disparities in mental health. We investigate whether adult socioeconomic status (SES) mediates the relationship between childhood trauma and antenatal depression. Methods: We analyzed data from two sociodemographically distinct peri-urban sites in the Western Cape, South Africa in a birth cohort study, the Drakenstein Child Health Study: Mbekweni (N = 510) and TC Newman (N = 413). Data were collected from pregnant women between 28 and 32 weeks{\textquoteright} gestation. Results: Associations between trauma and depressive symptoms differed by site (χ2=2163.6, df = 1419, p < 0.01); direct effects of trauma on depression were 0.24 mean increased symptoms in Mbekweni (p < 0.01) and 0.47 in TC Newman (p < 0.01). Trauma was differentially associated with SES (Mbekweni: −0.10, p = 0.07; TC Newman: −0.05, p = 0.37) and SES with depression (Mbekweni: −0.18, p < 0.01; TC Newman: −0.02, p = 0.62) across both sites. Indirect effects of trauma on depression through SES were 0.018 (95% C.I. −0.002-0.039) in Mbekweni and 0.001 (95% C.I. −0.004-0.006) in TC Newman, suggesting mediation was not supported. SES was a stronger indicator of depression risk in relatively poorer Mbekweni. Conclusion: Neighborhood-level effects and poverty are potentially important modifiers, and points of intervention, for maternal mental health outcomes.",

keywords = "Birth cohort, Depression, Epidemiology, Poverty, Trauma",

author = "Tatini Mal-Sarkar and Katherine Keyes and Nastassja Koen and Whitney Barnett and Landon Myer and Caroline Rutherford and Zar, {Heather J.} and Stein, {Dan J.} and Crick Lund",

note = "Funding Information: The work was supported by the Bill and Melinda Gates Foundation [ OPP 1017641 ]; the National Research Foundation , South Africa; and the South African Medical Research Council . The views and opinions expressed are those of the authors and do not necessarily represent the official views of the SAMRC. None of the funders had any role in the development, execution, or writing of this manuscript. Publisher Copyright: {\textcopyright} 2021 The Author(s) Copyright: Copyright 2021 Elsevier B.V., All rights reserved.",

year = "2021",

month = jun,

doi = "10.1016/j.ssmph.2021.100770",

language = "English",

volume = "14",

journal = "SSM - Population Health",

issn = "2352-8273",

publisher = "Elsevier Limited",

}

TY - JOUR

T1 - The relationship between childhood trauma, socioeconomic status, and maternal depression among pregnant women in a South African birth cohort study

AU - Mal-Sarkar, Tatini

AU - Keyes, Katherine

AU - Koen, Nastassja

AU - Barnett, Whitney

AU - Myer, Landon

AU - Rutherford, Caroline

AU - Zar, Heather J.

AU - Stein, Dan J.

AU - Lund, Crick

N1 - Funding Information: The work was supported by the Bill and Melinda Gates Foundation [ OPP 1017641 ]; the National Research Foundation , South Africa; and the South African Medical Research Council . The views and opinions expressed are those of the authors and do not necessarily represent the official views of the SAMRC. None of the funders had any role in the development, execution, or writing of this manuscript. Publisher Copyright: © 2021 The Author(s) Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

PY - 2021/6

Y1 - 2021/6

N2 - Background: Maternal depression is an important cause of morbidity and mortality. Experiences of childhood trauma contribute to maternal depression, potentially causing adult socio-economic disparities in mental health. We investigate whether adult socioeconomic status (SES) mediates the relationship between childhood trauma and antenatal depression. Methods: We analyzed data from two sociodemographically distinct peri-urban sites in the Western Cape, South Africa in a birth cohort study, the Drakenstein Child Health Study: Mbekweni (N = 510) and TC Newman (N = 413). Data were collected from pregnant women between 28 and 32 weeks’ gestation. Results: Associations between trauma and depressive symptoms differed by site (χ2=2163.6, df = 1419, p < 0.01); direct effects of trauma on depression were 0.24 mean increased symptoms in Mbekweni (p < 0.01) and 0.47 in TC Newman (p < 0.01). Trauma was differentially associated with SES (Mbekweni: −0.10, p = 0.07; TC Newman: −0.05, p = 0.37) and SES with depression (Mbekweni: −0.18, p < 0.01; TC Newman: −0.02, p = 0.62) across both sites. Indirect effects of trauma on depression through SES were 0.018 (95% C.I. −0.002-0.039) in Mbekweni and 0.001 (95% C.I. −0.004-0.006) in TC Newman, suggesting mediation was not supported. SES was a stronger indicator of depression risk in relatively poorer Mbekweni. Conclusion: Neighborhood-level effects and poverty are potentially important modifiers, and points of intervention, for maternal mental health outcomes.

AB - Background: Maternal depression is an important cause of morbidity and mortality. Experiences of childhood trauma contribute to maternal depression, potentially causing adult socio-economic disparities in mental health. We investigate whether adult socioeconomic status (SES) mediates the relationship between childhood trauma and antenatal depression. Methods: We analyzed data from two sociodemographically distinct peri-urban sites in the Western Cape, South Africa in a birth cohort study, the Drakenstein Child Health Study: Mbekweni (N = 510) and TC Newman (N = 413). Data were collected from pregnant women between 28 and 32 weeks’ gestation. Results: Associations between trauma and depressive symptoms differed by site (χ2=2163.6, df = 1419, p < 0.01); direct effects of trauma on depression were 0.24 mean increased symptoms in Mbekweni (p < 0.01) and 0.47 in TC Newman (p < 0.01). Trauma was differentially associated with SES (Mbekweni: −0.10, p = 0.07; TC Newman: −0.05, p = 0.37) and SES with depression (Mbekweni: −0.18, p < 0.01; TC Newman: −0.02, p = 0.62) across both sites. Indirect effects of trauma on depression through SES were 0.018 (95% C.I. −0.002-0.039) in Mbekweni and 0.001 (95% C.I. −0.004-0.006) in TC Newman, suggesting mediation was not supported. SES was a stronger indicator of depression risk in relatively poorer Mbekweni. Conclusion: Neighborhood-level effects and poverty are potentially important modifiers, and points of intervention, for maternal mental health outcomes.

KW - Birth cohort

KW - Depression

KW - Epidemiology

KW - Poverty

KW - Trauma

UR - http://www.scopus.com/inward/record.url?scp=85103111933&partnerID=8YFLogxK

U2 - 10.1016/j.ssmph.2021.100770

DO - 10.1016/j.ssmph.2021.100770

M3 - Article

AN - SCOPUS:85103111933

SN - 2352-8273

VL - 14

JO - SSM - Population Health

JF - SSM - Population Health

M1 - 100770

ER -

The relationship between childhood trauma, socioeconomic status, and maternal depression among pregnant women in a South African birth cohort study

Abstract

Keywords

UN SDGs

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