Abstract summary 

Maternal depression is an important cause of morbidity and mortality. Experiences of childhood trauma contribute to maternal depression, potentially causing adult socio-economic disparities in mental health. We investigate whether adult socioeconomic status (SES) mediates the relationship between childhood trauma and antenatal depression.We analyzed data from two sociodemographically distinct peri-urban sites in the Western Cape, South Africa in a birth cohort study, the Drakenstein Child Health Study: Mbekweni (N = 510) and TC Newman (N = 413). Data were collected from pregnant women between 28 and 32 weeks' gestation.Associations between trauma and depressive symptoms differed by site ( =2163.6, df = 1419, p < 0.01); direct effects of trauma on depression were 0.24 mean increased symptoms in Mbekweni (p < 0.01) and 0.47 in TC Newman (p < 0.01). Trauma was differentially associated with SES (Mbekweni: -0.10, p = 0.07; TC Newman: -0.05, p = 0.37) and SES with depression (Mbekweni: -0.18, p < 0.01; TC Newman: -0.02, p = 0.62) across both sites. Indirect effects of trauma on depression through SES were 0.018 (95% C.I. -0.002-0.039) in Mbekweni and 0.001 (95% C.I. -0.004-0.006) in TC Newman, suggesting mediation was not supported. SES was a stronger indicator of depression risk in relatively poorer Mbekweni.Neighborhood-level effects and poverty are potentially important modifiers, and points of intervention, for maternal mental health outcomes.

Authors & Co-authors:  Mal-Sarkar Tatini T Keyes Katherine K Koen Nastassja N Barnett Whitney W Myer Landon L Rutherford Caroline C Zar Heather J HJ Stein Dan J DJ Lund Crick C

Study Outcome 

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