Associations of childhood maltreatment with pre-pregnancy obesity and maternal postpartum mental health: a cross-sectional study

Abstract

Pre-pregnancy obesity and postpartum mental disorders are prevalent health risks to both the mother and the offspring. The objective of our study was to examine whether a history of childhood maltreatment is associated with pre-pregnancy obesity and postpartum mental health and whether childhood maltreatment and pre-pregnancy BMI independently predict postpartum mental health. We obtained self-reported data from 741 postpartum women before 16 weeks after delivery (M = 8.1 weeks, SD = 3.2). Childhood sexual, physical, and emotional abuse and physical and emotional neglect were assessed with the Childhood Trauma Questionnaire. Depression and anxiety were assessed using the BDI and SCL-90-R. We conducted logistic regression models adjusted for demographic covariates and co-occurrence of different types of maltreatment. 7.6% of the included women entered pregnancy with obesity. Forty-six percent reported any type of childhood maltreatment. 6.4% displayed at least moderate postnatal depressive symptomatology and 20.5% scored above the 75th percentile for postpartum anxiety. Severe physical abuse, moderate emotional abuse and severe physical and emotional neglect were associated with pre-pregnancy obesity. After controlling for the presence of all other types of childhood maltreatment, only severe physical abuse was still predictive for pre-pregnancy obesity (adj.OR = 5.24, 95% CI = 1.15-23.75). Pre-pregnancy obesity was associated with an increased risk of postpartum depression (adj.OR = 2.55, 95% CI = 1.08-6.00) but not with elevated anxiety. Pre-pregnancy obesity and severe childhood sexual abuse independently predicted postpartum depression. After controlling for histories of different types of childhood maltreatment, the association between pre-pregnancy obesity and postpartum depression attenuated to non-significance. To our knowledge, this is the first study examining empirical relations between childhood maltreatment, pre-pregnancy BMI and postpartum mental health controlling for the co-occurrence of other maltreatment types. Childhood maltreatment has been found being associated with both pre-pregnancy obesity and impaired postpartum mental health and may at least partly account for the association between pre-pregnancy obesity and postpartum depression. Therefore childhood maltreatment is related to two common risk conditions during pregnancy and postpartum which bear several health risks for the mother and the child, and routine screening for histories of childhood maltreatment among pregnant women is warranted.