A Multi-Cohort Examination of the Independent Contributions of Maternal Childhood Adversity and Pregnancy Stressors to the Prediction of Children’s Anxiety and Depression

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Abstract

Women’s social experiences can have long-term implications for their offspring’s health, but little is known about the potential independent contributions of multiple periods of stress exposures over time. This study examined associations of maternal exposure to adversity in childhood and pregnancy with children’s anxiety and depression symptoms in a large, sociodemographically diverse sample. Participants were 1389 mother-child dyads (child age M = 8.83 years; SD = 0.66; 42% Black, 42% White; 6% Hispanic) in the ECHO-PATHWAYS Consortium’s three U.S. pregnancy cohorts. Women reported their exposure to childhood traumatic events (CTE) and pregnancy stressful life events (PSLE). Children self-reported on their symptoms of anxiety and depression at age 8–9 years. Regression analyses estimated associations between maternal stressors and children’s internalizing problems, adjusting for confounders, and examined child sex as a modifier. Exploratory interaction analyses examined whether geospatially-linked postnatal neighborhood quality buffered effects. In adjusted models, PSLE counts positively predicted levels of children’s anxiety and depression symptoms ([ß _Anxiety=0.08, 95%CI [0.02, 0.13]; ß _Depression=0.09, 95%CI [0.03, 0.14]); no significant associations were observed with CTE. Each additional PSLE increased odds of clinically significant anxiety symptoms by 9% (95%CI [0.02, 0.17]). Neither sex nor neighborhood quality moderated relations. Maternal stressors during pregnancy appear to have associations with middle childhood anxiety and depression across diverse sociodemographic contexts, whereas maternal history of childhood adversity may not. Effects appear comparable for boys and girls. Policies and programs addressing prevention of childhood internalizing symptoms may benefit from considering prenatal origins and the potential two-generation impact of pregnancy stress prevention and intervention.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10802-022-01002-3.

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Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Theo Vos, Stephen S Lim, Cristiana Abbafati … (2023)

Summary Background In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990–2010 time period, with the greatest annualised rate of decline occurring in the 0–9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10–24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10–24 years were also in the top ten in the 25–49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50–74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and development investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Funding Bill & Melinda Gates Foundation.

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Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study.

V. Felitti, R F Anda, D Nordenberg … (1998)

The relationship of health risk behavior and disease in adulthood to the breadth of exposure to childhood emotional, physical, or sexual abuse, and household dysfunction during childhood has not previously been described. A questionnaire about adverse childhood experiences was mailed to 13,494 adults who had completed a standardized medical evaluation at a large HMO; 9,508 (70.5%) responded. Seven categories of adverse childhood experiences were studied: psychological, physical, or sexual abuse; violence against mother; or living with household members who were substance abusers, mentally ill or suicidal, or ever imprisoned. The number of categories of these adverse childhood experiences was then compared to measures of adult risk behavior, health status, and disease. Logistic regression was used to adjust for effects of demographic factors on the association between the cumulative number of categories of childhood exposures (range: 0-7) and risk factors for the leading causes of death in adult life. More than half of respondents reported at least one, and one-fourth reported > or = 2 categories of childhood exposures. We found a graded relationship between the number of categories of childhood exposure and each of the adult health risk behaviors and diseases that were studied (P or = 50 sexual intercourse partners, and sexually transmitted disease; and 1.4- to 1.6-fold increase in physical inactivity and severe obesity. The number of categories of adverse childhood exposures showed a graded relationship to the presence of adult diseases including ischemic heart disease, cancer, chronic lung disease, skeletal fractures, and liver disease. The seven categories of adverse childhood experiences were strongly interrelated and persons with multiple categories of childhood exposure were likely to have multiple health risk factors later in life. We found a strong graded relationship between the breadth of exposure to abuse or household dysfunction during childhood and multiple risk factors for several of the leading causes of death in adults.

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Twelve-month and lifetime prevalence and lifetime morbid risk of anxiety and mood disorders in the United States.

Ronald C Kessler, Maria Petukhova, Nancy Sampson … (2012)

Estimates of 12-month and lifetime prevalence and of lifetime morbid risk (LMR) of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) anxiety and mood disorders are presented based on US epidemiological surveys among people aged 13+. The presentation is designed for use in the upcoming DSM-5 manual to provide more coherent estimates than would otherwise be available. Prevalence estimates are presented for the age groups proposed by DSM-5 workgroups as the most useful to consider for policy planning purposes. The LMR/12-month prevalence estimates ranked by frequency are as follows: major depressive episode: 29.9%/8.6%; specific phobia: 18.4/12.1%; social phobia: 13.0/7.4%; post-traumatic stress disorder: 10.1/3.7%; generalized anxiety disorder: 9.0/2.0%; separation anxiety disorder: 8.7/1.2%; panic disorder: 6.8%/2.4%; bipolar disorder: 4.1/1.8%; agoraphobia: 3.7/1.7%; obsessive-compulsive disorder: 2.7/1.2. Four broad patterns of results are most noteworthy: first, that the most common (lifetime prevalence/morbid risk) lifetime anxiety-mood disorders in the United States are major depression (16.6/29.9%), specific phobia (15.6/18.4%), and social phobia (10.7/13.0%) and the least common are agoraphobia (2.5/3.7%) and obsessive-compulsive disorder (2.3/2.7%); second, that the anxiety-mood disorders with the earlier median ages-of-onset are phobias and separation anxiety disorder (ages 15-17) and those with the latest are panic disorder, major depression, and generalized anxiety disorder (ages 23-30); third, that LMR is considerably higher than lifetime prevalence for most anxiety-mood disorders, although the magnitude of this difference is much higher for disorders with later than earlier ages-of-onset; and fourth, that the ratio of 12-month to lifetime prevalence, roughly characterizing persistence, varies meaningfully in ways consistent with independent evidence about differential persistence of these disorders. Copyright © 2012 John Wiley & Sons, Ltd.

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Author and article information

Contributors

Amanda Noroña-Zhou: amanda.norona-zhou@ucsf.edu

Michael Coccia: Michael.coccia@ucsf.edu

Alexis Sullivan: alexis.sullivan@ucsf.edu

Thomas G. O’Connor: Tom_OConnor@URMC.Rochester.edu

Brent R. Collett: brent.collett@seattlechildrens.org

Karen Derefinko: kderefin@uthsc.edu

Lynette M. Renner: renn0042@umn.edu

Christine T. Loftus: cloftus@uw.edu

Danielle Roubinov: Danielle.roubinov@ucsf.edu

Kecia N. Carroll: kecia.carroll@mssm.edu

Ruby H. N. Nguyen: nguy0082@umn.edu

Catherine J. Karr: ckarr@uw.edu

Sheela Sathyanarayana: sheela.sathyanarayana@seattlechildrens.org

Emily S. Barrett: esb104@eohsi.rutgers.edu

W. Alex Mason: wmason7@uthsc.edu

Kaja Z. LeWinn: kaja.lewinn@ucsf.edu

Nicole R. Bush: nicole.bush@ucsf.edu

Journal

Journal ID (nlm-ta): Res Child Adolesc Psychopathol

Journal ID (iso-abbrev): Res Child Adolesc Psychopathol

Title: Research on Child and Adolescent Psychopathology

Publisher: Springer US (New York )

ISSN (Print): 2730-7166

ISSN (Electronic): 2730-7174

Publication date (Electronic): 3 December 2022

Publication date PMC-release: 3 December 2022

Publication date (Print): 2023

Volume: 51

Issue: 4

Pages: 497-512

Affiliations

[1 ]GRID grid.266102.1, ISNI 0000 0001 2297 6811, Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, , University of California, San Francisco (UCSF), ; San Francisco, CA USA

[2 ]GRID grid.266102.1, ISNI 0000 0001 2297 6811, Department of Pediatrics, , UCSF, ; San Francisco, CA USA

[3 ]GRID grid.266102.1, ISNI 0000 0001 2297 6811, Center for Health and Community, , UCSF, ; San Francisco, CA USA

[4 ]GRID grid.16416.34, ISNI 0000 0004 1936 9174, Departments of Psychiatry, Psychology, Neuroscience, Department of Obstetrics & Gynecology, , University of Rochester, ; Rochester, NY USA

[5 ]GRID grid.34477.33, ISNI 0000000122986657, Department of Psychiatry & Behavioral Sciences, , University of Washington, Seattle Children’s Research Institute, ; Seattle, WA USA

[6 ]GRID grid.267301.1, ISNI 0000 0004 0386 9246, Department of Preventive Medicine, , University of Tennessee Health Science Center, ; Memphis, TN USA

[7 ]GRID grid.17635.36, ISNI 0000000419368657, School of Social Work, , University of Minnesota, ; Minneapolis, MN USA

[8 ]GRID grid.34477.33, ISNI 0000000122986657, Department of Occupational and Environmental Health Sciences, , University of Washington, ; Seattle, WA USA

[9 ]GRID grid.59734.3c, ISNI 0000 0001 0670 2351, Departments of Environmental Medicine and Public Health and Pediatrics, , Icahn School of Medicine at Mount Sinai, ; New York, NY USA

[10 ]GRID grid.17635.36, ISNI 0000000419368657, Division of Epidemiology and Community Health, , University of Minnesota, ; Minneapolis, MN USA

[11 ]GRID grid.34477.33, ISNI 0000000122986657, Department of Occupational and Environmental Health Sciences, Department of Pediatrics, , University of Washington, ; Seattle, WA USA

[12 ]GRID grid.430387.b, ISNI 0000 0004 1936 8796, Department of Biostatistics and Epidemiology, Rutgers School of Public Health; Environmental and Occupational Health Sciences Institute, , Rutgers University, ; New Brunswick, NJ USA

Article

Publisher ID: 1002

DOI: 10.1007/s10802-022-01002-3

PMC ID: 10017630

PubMed ID: 36462137

SO-VID: 4f411d95-4fd4-489f-9716-6e38154fc6da

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

History

Date accepted : 18 November 2022

Funding

Funded by: National Institute of Health Environmental influences on Child Health Outcomes (ECHO) Program

Award ID: 1UG3OD023271

Award ID: 4UH3OD023271

Funded by: FundRef http://dx.doi.org/10.13039/100000066, National Institute of Environmental Health Sciences;

Award ID: 1R01ES25169

Award ID: P30ES005022

Funded by: FundRef http://dx.doi.org/10.13039/100000050, National Heart, Lung, and Blood Institute;

Award ID: 1R01HL109977

Funded by: FundRef http://dx.doi.org/10.13039/100017476, Urban Child Institute;

Award ID: Urban Child Institute

Award Recipient : W. Alex Mason

Funded by: Lisa Stone Pritzker Family Foundation

Award ID: Lisa Stone Pritzker Family Foundation

Funded by: FundRef http://dx.doi.org/10.13039/100006108, National Center for Advancing Translational Sciences;

Award ID: UL1TR002319

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Keywords: child anxiety,child depression,childhood trauma,pregnancy stress,intergenerational transmission

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Keywords: child anxiety, child depression, childhood trauma, pregnancy stress, intergenerational transmission

A Multi-Cohort Examination of the Independent Contributions of Maternal Childhood Adversity and Pregnancy Stressors to the Prediction of Children’s Anxiety and Depression

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HLA-G and immune tolerance in pregnancy

Most cited references 66

Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study.

Twelve-month and lifetime prevalence and lifetime morbid risk of anxiety and mood disorders in the United States.

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