Childhood adversity, prenatal depression, and maternal inflammation across pregnancy

Abstract

Background: To examine whether change in neutrophil-lymphocyte ratio, a marker of systemic inflammation, differs by childhood adversity and prenatal depression.

Methods: Prenatal complete blood count data were used to calculate neutrophil-lymphocyte ratio in first and third trimesters. The Adverse Childhood Experiences scale measured childhood adversity, and the Patient Health Questionnaire-9 measured depression. This is a secondary analysis of a study of predictors of risk for sleep-disordered breathing.

Results: Participants were 98 pregnant women, mean age 30 years (SD = 5), mean body mass index of 35 kg/m² (SD = 7), 61% identified as white, and 28% identified as Hispanic. Women who reported childhood sexual abuse history displayed greater increase in neutrophil-lymphocyte ratio over pregnancy relative to women without childhood sexual abuse. Change in neutrophil-lymphocyte ratio across pregnancy did not differ by prenatal depression.

Conclusion: Experiences of sexual abuse in childhood may impact markers of systemic inflammation in pregnancy.

Keywords: Pregnancy; childhood adversity; inflammation; lymphocyte; neutrophil; prenatal depression.

Figure 1.

Pregnant women who experienced childhood sexual abuse, but not prenatal depression, exhibited greater increases in systemic inflammation over pregnancy. (a) Maternal history of childhood sexual abuse and neutrophil-to-lymphocyte ratio. (b) Prenatal depression and neutrophil-to-lymphocyte ratio. Note: Childhood adversity was measured using the Adverse Childhood Experiences Scale. Prenatal depression was measured using the Patient Health Questionnaire 9 (PHQ9). Neutrophils and lymphocytes were collected during routine prenatal care. The neutrophil-to-lymphocyte ratios were log transformed for analyses. We categorized women based on those with and without histories of childhood sexual abuse (a), and those with and without prenatal depression (b). Models adjusted for age, BMI, race, cigarette smoking in pregnancy, and obstructive sleep apnea diagnosis. Error bars reflect standard errors. CSA: childhood sexual abuse.