Abstract 30: Role For Adverse Childhood Experiences And Depression In Preeclampsia

Abstract

Hypertensive diseases are associated with adverse experiences in childhood as well as depression. In order to determine if these associations were present in women with preeclampsia (PreE), a particularly devastating hypertensive disease in pregnancy, the scores from three questionnaires: Adverse Childhood Experiences (ACE), Edinburgh Postnatal Depression Scale (EPDS), and the Patient Health Questionnaire-9 (PHQ-9) were compared between women with PreE (n=32) and women without PreE (n=46) between 9 and 48 months postpartum (IRB# 201808705). ACE scores are calculated by summing an individual’s affirmative responses to specific adverse experiences during childhood. In our study, the average ACE score of individuals with PreE was higher than that of women without PreE (1.69 vs. 1.02, P=.04). We also divided women into groups based on whether their ACE score was ≤3 or ≥4 due to evidence that individuals who have experienced ≥4 ACEs are at greatest risk for physical and mental health conditions. Among our participants, 80% of women with an ACE score ≥4 (n=10) had PreE while only 35.3% of women with a score ≤3 (n=68) developed the condition (P=0.01). As well, the odds of having PreE were higher in those with ACE scores ≥4, compared with those with scores ≤3 (OR= 7.34; 95% CI = 1.44, 37.33). In a subset of participants, scores were available from EPDS, survey that identifies women who have postpartum depression 6 weeks after birth, and from the PHQ-9, another assessment for depression. Among our participants, the average EPDS score was higher in women with PreE than women without PreE (6.38, n=21 vs. 3.71, n=42 P=0.01), indicating more severe symptoms of postpartum depression in women who also had PreE. In addition, the average PHQ-9 score among women with PreE was higher than that of women without PreE (3.71, n=15 vs 1.86, n=37 P=.02) with a higher score indicating more severe depression. The average PHQ-9 score was also higher in women who had ACE scores ≥4 than women with scores ≤3 (4.00, n=4 vs. 2.27, n=48 P=.01) indicating that women with more adverse childhood events were more likely to experience depression. Together, these findings indicate that PreE may be associated with adverse events during childhood as well as depression in late pregnancy and/or postpartum.