Patterns of adverse and positive childhood experiences on prenatal mental health outcomes in Chinese pregnant women: A latent class analysis.

BACKGROUND

Early life experiences, including adverse childhood experiences (ACEs) and positive childhood experiences (PCEs), are established factors affecting prenatal mental health. But understandings remained unclear on the patterns and effects of the co-occurrence of ACEs and PCEs.

OBJECTIVE

To identify the latent classes of ACEs and PCEs and assess the association of the distinct classes with prenatal mental health outcomes.

PARTICIPANTS AND

SETTING

This was a cross-sectional study in 936 Chinese pregnant women (mean age 30.98 [SD 0.27] years).

METHODS

ACEs, PCEs, prenatal depression symptoms, and mental well-being were measured by ACE International Questionnaire, Benevolent Childhood Experiences Scale, Edinburgh Postnatal Depression Scale, and Short Warwick-Edinburgh Mental Well-being Scale, respectively. Latent class analysis was used to identify distinct latent classes. Multivariable linear regression examined the associations of different classes with prenatal mental health outcomes, adjusting for demographic, lifestyle, and pregnancy-related covariates.

RESULTS

4 classes of ACEs and PCEs were identified, including high adversity/low positivity (8.1%), high adversity/moderate positivity (30.1%), low adversity/low positivity (14.1%), and low adversity/high positivity (47.7%). Relative to low adversity/high positivity class, high adversity/low positivity class was associated with the highest level of prenatal depression symptoms (adjusted b = 3.72, 95%CI 2.34, 5.09) and poorest mental well-being (adjusted b = -4.70, 95%CI -5.73, -3.67), followed by high adversity/moderate positivity class. Low adversity/low positivity class was solely associated with mental well-being.

CONCLUSIONS

Our results showed 4 classes of ACEs and PCEs and their different associations with prenatal mental health outcomes, which warranted studies using longitudinal design and larger sample sizes with representative samples to confirm.