A Latent Class Analysis of Maternal Adverse Childhood, Adult, and Postpartum Experiences: Implications for Health and Development

• In Event: 2-092 - Intergenerational Risk and Resilience: Continuity, Discontinuity, and Mechanisms of Transmission

Integrative Statement

According to Life Course Theory, the timing of experiences and events across the lifespan have the potential to alter developmental trajectories (Elder, 1998). Decades of research have demonstrated the deleterious impact of adversity on long-term health and well-being (Kaplow & Widom, 2007, Raby et al., 2018); however, less understood is how adversity at different stages of the life course is transmitted across generations. Specifically, little is known about whether adversity experienced in childhood (i.e., a sensitive period) versus adulthood (i.e., recency effect) is associated with intergenerational transmission of adversity to child development outcomes (Kaplow & Widom, 2007). The current study used a person-centered approach to examine whether groups of mothers exist who have experienced adversity at different stages across the life course and if so, whether these groups have differential postpartum and intergenerational child outcomes. A person-centered approach allows the identification of specific at-risk groups who may not be identified at the level of the entire sample. In the current study, groups of mothers were identified based on adversity experienced in childhood, adulthood, and the postpartum period. Maternal health and child development outcomes were investigated as sequalae of these groups.

Participants were 3,388 women (mean age = 30.60 yrs) and their infant who were recruited in pregnancy as part of a prospective longitudinal cohort study. Pregnant women completed self-report questionnaires indicating whether or not they had experienced physical, sexual, or emotional abuse in childhood, adulthood, and the postpartum period. At 4 months postpartum, mothers reported on their symptoms of depression (Edinburgh Postnatal Depression Scale, Cox et al., 1987), anxiety (State-Trait Anxiety Inventory, Spielberger, 1970) and quality of life (SF-12, Ware et al., 1996). Mothers completed the Ages and Stages Questionnaires (Squires et al., 1997) when their child was 36-months of age.

Results of the Latent Class Analysis (LCA), which controlled for household income, maternal education, and maternal age, yielded three distinct abuse classes (see Figure 1): Low Abuse (86.2%), Childhood Abuse (7.4%), and Recent Abuse (6.3%). Mothers in the Child Abuse and Recent Abuse groups had higher levels of postpartum depression, anxiety, and lower quality of life than mothers in the Low Abuse group. Children of mothers in the Child Abuse and Recent Abuse groups had lower communication scores on the Ages and Stages questionnaire and higher levels of hyperactivity on the CBCL at 36 months of age.

The present findings suggest that maternal adversity experienced in childhood and in adulthood is associated with maternal mental health outcomes in the postpartum period. These abuse experiences are also associated with some intergenerational outcomes in terms of child development. Findings have implications for identification and treatment of mothers who have experienced adversity across the lifespan, rather than an exclusive focus on screening for childhood abuse only.

Authors

• Nicole Racine, University of Calgary
  Presenting Author

• Andre Plamondon, Université Laval
  Non-Presenting Author

• Shelia McDonald, Department of Pediatrics, University of Calgary
  Non-Presenting Author

• Suzanne Tough, Department of Pediatrics, University of Calgary
  Non-Presenting Author

• Sheri Madigan, University of Calgary and the Alberta Children’s Hospital Research Institute, Calgary
  Non-Presenting Author