Positive Childhood Experiences Relate to Prenatal Mental Health Symptoms and Diagnoses Independent of Childhood Maltreatment

Purpose Prenatal mental health problems often impair maternal functioning and offspring development. Maternal childhood maltreatment is a well-established risk factor for prenatal mental health problems; however, growing evidence supports the health-promoting role of positive childhood experiences (PCEs) for better prenatal mental health. Yet joint effects of childhood maltreatment and PCEs on prenatal mental illness diagnoses, in addition to symptoms, are not understood. Methods This study examined associations between childhood maltreatment and PCEs on prenatal mental health symptoms and clinical diagnoses in 234 pregnant individuals ( M gestational age: 16.7 weeks). Childhood maltreatment, PCEs, and prenatal depression, anxiety, and posttraumatic stress disorder (PTSD) symptoms were assessed with standardized self-report measures. Prenatal Major Depressive Disorder (MDD) and Generalized Anxiety Disorder (GAD) during adulthood were assessed during pregnancy via structured clinical interviews. Results Higher levels of childhood maltreatment predicted greater symptom levels of depression, anxiety, and PTSD during pregnancy (effect sizes: 0.17 to 0.23) and elevated of prenatal MDD and adult GAD (ORs: 1.31, 1.32). In contrast, higher levels of PCEs predicted less symptom severity across all domains (effect sizes: -0.31 to -0.38) and lower MDD and GAD rates (ORs: 0.68, 0.70). When maltreatment and PCEs were modeled simultaneously, PCEs were the only significant predictor of fewer symptoms and diagnoses across all domains (effect sizes: -0.29 to -0.35; ORs: 0.68, 0.70), whereas effects of childhood maltreatment dropped to non-significance. Conclusion Positive childhood experiences have enduring effects, predicting both dimensional and categorical prenatal mental health above and beyond childhood maltreatment.