Associations of childhood and adulthood maltreatment with postpartum depression and the role of socio-economic position and social contact.

BACKGROUND

Postpartum depression (PPD) is a critical maternal health issue, yet the impact of maltreatment in childhood and adulthood on PPD, the roles of socio-economic position (SEP) and social contact are unclear.

METHODS

This cohort study included 16,886 postpartum women from the UK Biobank. We employed multivariable logistic regression and mediation models to assess associations of childhood (emotional, physical, and sexual abuse; emotional and physical neglect) and adulthood (physical violence, sexual harassment) maltreatment with PPD, and the interactions and mediations of SEP and social contact.

RESULTS

Both childhood and adulthood maltreatment were associated with increased PPD risk in a dose-response manner. Experiencing ≥3 childhood or both adulthood maltreatment subtypes increased PPD risk by 58 % (95 % CI: 31 %, 72 %) and 21 % (95 % CI: 11 %, 38 %), respectively, compared to no maltreatment. Childhood physical abuse showed the strongest individual effect (Odds ratio = 1.29, 95 % CI: 1.13-1.49). Joint analysis revealed a synergistic effect; combined exposure to ≥2 childhood and ≥1 adulthood maltreatment subtypes posed the highest risk. Higher SEP and more social contact significantly attenuated these associations (Pint <0.05), but no significant mediation was observed. Stronger maltreatment-associated PPD risk was also seen in women with non-optimal delivery age, obesity, adverse pregnancy history, or lack of psychiatric care.

CONCLUSION

Maltreatment in childhood and adulthood and its subtypes were synergistically associated with increased PPD risk, attenuated by improved SEP and social contact.