title: Depressive symptoms in disadvantaged women receiving prenatal care: the influence of adverse and positive childhood experiences.
abstract: OBJECTIVE
  To determine the association between adverse childhood experiences (ACEs), positive influences in childhood (PICs), and depressive symptoms among low-income pregnant women.
  
  
  METHODS
  Face-to-face survey of women receiving prenatal care at Philadelphia community health centers. We conducted surveys at the first prenatal care visit and at a mean age +/- standard deviation of 11 +/- 1 months postpartum, and obtained information on sociodemographic characteristics and childhood experiences before age 16. Group differences were tested with respect to a cutpoint of 23 on the Center for Epidemiologic Studies-Depression scale (CES-D), with the chi(2) test used for categorical variables and the Student's t test used for continuous variables. Logistic regression analyses were conducted to adjust for potential confounding variables.
  
  
  RESULTS
  The sample consisted of 1476 mostly young, African American, low-income women. The majority (70% and 90%, respectively) of women reported at least one ACE and one PIC. For each ACE, affected women were more likely to have depressive symptoms than their counterparts. There was a dose-response effect in that a higher number of ACEs was associated with a higher likelihood of having depressive symptoms. PICs, on the other hand, were associated with a lower likelihood of having depressive symptoms.
  
  
  CONCLUSIONS
  Among low-income women, ACEs were associated with a higher likelihood of having depressive symptoms in a dose-response fashion, and PICs were associated with a lower risk. Efforts to prevent ACEs and to promote PICs might help reduce the risk of depressive symptoms and their associated problems in adulthood.
authors: Department of Pediatrics, Alfred I. duPont Hospital for Children, Wilmington, Delaware, USA. echung@nemours.org
authors: Esther K
authors: EK
authors: Chung
authors: Leny
authors: L
authors: Mathew
authors: Irma T
authors: IT
authors: Elo
authors: James C
authors: JC
authors: Coyne
authors: Jennifer F
authors: JF
authors: Culhane
mesh_terms: D000293:Adolescent; D000328:Adult; D002649:Child Abuse / Q000523:psychology*; D015331:Cohort Studies; D003863:Depression / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007182:Income; D008016:Life Change Events; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011295:Prenatal Care; D035862:Vulnerable Populations