Maternal adverse childhood experiences and prenatal stress: Intergenerational transmission and offspring mental health in the ECHO Cohort.

Maternal ACEs were significantly associated with child mental health problems after adjusting for confounders.

• Analysis conducted in a subsample of N = 2,906 parent-child dyads from 34 sites in the ECHO Cohort.
• B = 2.53 (95% CI: 2.09, 2.96), p < 0.0001.
• Child ages ranged from 1.5 to 18 years.
• Regression analyses adjusted for confounders were used to evaluate study aims.

Perceived prenatal stress was significantly associated with child mental health problems after adjusting for confounders.

• Analysis conducted in a subsample of N = 4,441 parent-child dyads.
• B = 2.36 (95% CI: 2.03, 2.68), p < 0.0001.
• Prenatal stress was measured as perceived stress during pregnancy.
• This association was independent of maternal ACEs in the combined subsample.

Maternal ACEs and prenatal stress were independently associated with child mental health problems among participants with data on both stress exposures.

• This analysis was conducted in a subsample of N = 834 participants with data on both exposures.
• Maternal ACEs: B = 1.72 (95% CI: 0.96, 2.48), p < 0.0001.
• Prenatal stress: B = 2.05 (95% CI: 1.29, 2.80), p < 0.0001.
• Both associations remained statistically significant when entered simultaneously into the model.

Neither maternal ACEs nor child sex modified the association between prenatal stress and child mental health problems.

• Interaction tests were conducted to determine potential effect modifiers.
• Maternal ACEs were tested as a potential moderator of the prenatal stress–child mental health association.
• Child sex was also tested as a potential moderator.
• Neither interaction was statistically significant.

The study used data from 34 sites in the nationwide Environmental Influences on Child Health Outcomes (ECHO) Cohort.

• Three subsamples were organized: (1) maternal ACEs only (N = 2,906), (2) perceived prenatal stress only (N = 4,441), and (3) both stress exposures (N = 834).
• Eligible parent-child dyads provided data on at least one measure of maternal stress and at least one measure of child mental health.
• Child ages spanned 1.5 to 18 years.
• Regression analyses with confounder adjustment and interaction tests were the primary analytic approach.