Maternal childhood trauma, postpartum depression, and infant outcomes: Avoidant affective processing as a potential mechanism

J Affect Disord. 2017 Mar 15;211:107-115. doi: 10.1016/j.jad.2017.01.004. Epub 2017 Jan 8.


Background: Women who have experienced childhood trauma may be at risk for postpartum depression, increasing the likelihood of negative outcomes among their children. Predictive pathways from maternal childhood trauma to child outcomes, as mediated by postpartum depression, require investigation.

Methods: A longitudinal sample of South African women (N=150) was followed through pregnancy and postpartum. Measures included maternal trauma history reported during pregnancy; postpartum depression through six months; and maternal-infant bonding, infant development, and infant physical growth at one year. Structural equation models tested postpartum depression as a mediator between maternal experiences of childhood trauma and children's outcomes. A subset of women (N=33) also participated in a lab-based emotional Stroop paradigm, and their responses to fearful stimuli at six weeks were explored as a potential mechanism linking maternal childhood trauma, postpartum depression, and child outcomes.

Results: Women with childhood trauma experienced greater depressive symptoms through six months postpartum, which then predicted negative child outcomes at one year. Mediating effects of postpartum depression were significant, and persisted for maternal-infant bonding and infant growth after controlling for covariates and antenatal distress. Maternal avoidance of fearful stimuli emerged as a potential affective mechanism.

Limitations: Limitations included modest sample size, self-report measures, and unmeasured potential confounders.

Conclusions: Findings suggest a mediating role of postpartum depression in the intergenerational transmission of negative outcomes. Perinatal interventions that address maternal trauma histories and depression, as well as underlying affective mechanisms, may help interrupt cycles of disadvantage, particularly in high-trauma settings such as South Africa.

Keywords: Child outcomes; Early adversity; Emotion processing; Emotional Stroop; Intergenerational transmission; Perinatal depression; South Africa.

MeSH terms

  • Adult
  • Adult Survivors of Child Adverse Events / psychology
  • Adult Survivors of Child Adverse Events / statistics & numerical data*
  • Child
  • Child Development
  • Depression / etiology
  • Depression / psychology
  • Depression, Postpartum / etiology
  • Depression, Postpartum / psychology*
  • Female
  • Humans
  • Infant
  • Longitudinal Studies
  • Object Attachment*
  • Parturition
  • Postpartum Period / psychology*
  • Pregnancy
  • South Africa
  • Young Adult