Maternal Traumatic Violence and Offspring Temperament: A Moderated Mediation Model of Stress Sensitization During Pregnancy

• In Event: 3-209 - Maternal Traumatic Stress Before and During Pregnancy: Pathways to Offspring Development

Integrative Statement

Introduction: A growing body of evidence suggests that maternal exposure to traumatic violence before conception can have enduring effects on maternal mental health and may further influence offspring temperamental responses to the environment. Although the mechanisms through which maternal history of violence is intergenerationally transmitted to offspring is unclear, one plausible pathway is through fetal exposure to maternal stress during pregnancy. Indeed, women with childhood trauma histories, such as witnessing frequent domestic violence (DV), have increased risk for prenatal stress and anxiety during pregnancy, which may shape the development of offspring temperament through prenatal programming effects. According to the stress sensitization hypothesis (Hammen, Henry, & Daley, 2000), the effect of early trauma may be further amplified for women re-exposed to traumatic violence from their intimate partner during pregnancy. Hypotheses: The present study hypothesized that the association between preconception DV and offspring temperament would be mediated by prenatal anxiety, with effects particularly heightened for women exposed to intimate partner violence (IPV) during pregnancy. Study population: Participants included 161 first-time mothers (aged 19-24) and their 6-month old infants. Women were initially recruited as part of a longitudinal study of urban-living girls assessed annually since childhood (52% African-American; 33% receiving public assistance). Methods: Mothers’ childhood history of DV was prospectively assessed from ages 8-17 including self- and parent-reported measures (Conflict Tactics Scale-2, Child Police Contact, Difficult Life Circumstances). During pregnancy, women were evaluated for IPV victimization (Conflict Tactics Scale-2) and prenatal state and trait anxiety (State-Trait Anxiety Inventory). When offspring were 6-months old, mothers completed the Infant Characteristics Questionnaire, including assessment of infant fussiness (e.g., negative affectivity) and unpredictability (e.g., regularity of mood, sleep). Moderated mediation models were conducted in Mplus and rigorously controlled for potential confounding factors including preconception anxiety, prenatal depression, alcohol, and marijuana use, postnatal IPV, and infant biological sex. Results: Controlling for preconception anxiety, maternal history of childhood DV did not have a significant direct effect on prenatal state nor trait anxiety; instead, both pathways were moderated by prenatal IPV exposure (Figure 1). Post hoc analyses revealed that DV history predicted both trait (p = .02) and state anxiety (p < .01) during pregnancy for women exposed to concurrent prenatal IPV, whereas this association was not significant for pregnant women without IPV exposure (p > .05) (Figure 2). Prenatal trait anxiety, in turn, predicted offspring infant unpredictability. Conclusions: Results are consistent with stress sensitization theory, such that maternal childhood history of witnessing DV increased vulnerability to prenatal anxiety, but only when women were directly re-exposed to IPV during pregnancy. Thus, preconception trauma may influence offspring temperament by heightening maternal sensitivity to traumatic stress during pregnancy. Findings emphasize the importance of screening for both history of traumatic violence as well as concurrent violence exposure, given that they may synergistically influence prenatal health and offspring outcomes. Results also highlight the resilience of women exposed to childhood DV, given that many women with childhood exposure, but not prenatal adult exposure, to violence did not develop prenatal anxiety.

Authors

• Irene Tung, University of Pittsburgh
  Presenting Author

• Kate Keenan, University of Chicago
  Non-Presenting Author

• Stephanie D. Stepp, University of Pittsburgh
  Non-Presenting Author

• Alison Hipwell, University of Pittsburgh
  Non-Presenting Author