Abstract
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.