Associiation of adverse childhood experiences of pregnant women with emotional and behavioral development trajectories of young children and the mediating role of prenatal depression symptom

XIONG Lu; LI Jiayu; LI Yili; CHEN Xueqing; CHAI Yining; ZHU Yuanzhong; ZHU Yulong; YU Bin; YAN Hong

doi:10.11852/zgetbjzz2025-0105

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Chinese Journal of Child Health Care ›› 2026, Vol. 34 ›› Issue (6) : 649-655. DOI: 10.11852/zgetbjzz2025-0105

Associiation of adverse childhood experiences of pregnant women with emotional and behavioral development trajectories of young children and the mediating role of prenatal depression symptom

XIONG Lu¹, LI Jiayu¹, LI Yili², CHEN Xueqing¹, CHAI Yining¹, ZHU Yuanzhong¹, ZHU Yulong¹, YU Bin¹, YAN Hong¹

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Abstract

Objective To explore the mediating role of prenatal depression symptoms in the association of adverse childhood experiences (ACEs) with emotional and behavioral development trajectories in young children, so as to provide reference for the prevention and intervention of children′s mental problems. Methods A maternal-infant health cohort was established from April to July 2020.Basic information was collected from pregnant women in their third trimester using questionnaires.The Edinburgh Postnatal Depression Scale and the Adverse Childhood Experiences Questionnaire were used to assess relevant factors.Offspring emotional and behavioral problems were evaluated at 12, 18, 24, and 36 months of age.Mediating analysis was conducted to examine the relationships among variables. Results A total of 125 mother-child pairs were included.Among them, 27.20% (34/125) of the pregnant women had ACEs, and the rate of prenatal depression symptoms was 28.80% (36/125).ACEs may influence the developmental trajectory of dysregulation in offspring through maternal prenatal depressive symptoms.The indirect effect of prenatal depressive symptoms was 0.12 (95% CI: 0.02 - 0.27), accounting for 48.17% of the total effect. Conclusions Maternal prenatal depressive symptoms may mediate the association between ACEs and emotional-behavioral development trajectories in offspring.Preconception counseling and prenatal care should focus on women′s early-life environments and emotional status during pregnancy.

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pregnant women / adverse childhood experiences / prenatal depressive symptoms / emotional and behavioral problems / mediating analysis

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XIONG Lu, LI Jiayu, LI Yili, CHEN Xueqing, CHAI Yining, ZHU Yuanzhong, ZHU Yulong, YU Bin, YAN Hong. Associiation of adverse childhood experiences of pregnant women with emotional and behavioral development trajectories of young children and the mediating role of prenatal depression symptom[J]. Chinese Journal of Child Health Care. 2026, 34(6): 649-655 https://doi.org/10.11852/zgetbjzz2025-0105

References

[1] 朱香昱,张旎,王端,等.儿童情绪行为问题——一个不能忽视的现象[J].中国实用儿科杂志,2022,37(11): 804-807.
Zhu XY, Zhang N, Wang D, et al.Emotional behavioral problems in children: A phenomenon that cannot be ignored[J].Chin J Pract Pediatr, 2022, 37 (11): 804-807.(in Chinese)
[2] 黄广文,吴虹,刘智昱,等.1280名3～6岁儿童情绪与行为问题调查研究[J].中国儿童保健杂志,2012,20(7): 595-597,603.
Huang GW, Wu H, Liu ZY, et al.Investigation on emotion and behavior problems among1280 children aged 3 to 6 years old[J].Chin J Child Health Care, 2012,20(7):595-597,603.(in Chinese)
[3] 何海燕,宁曼,王睿,等.学龄前儿童睡眠障碍与情绪行为问题的关联[J].中国学校卫生,2021,42(9): 1344-1347.
He HY, Ning M, Wang R, et al.Association between sleep disorders and behavioral problems in preschool children[J].Chin J Sch Health, 2021,42(9): 1344-1347.(in Chinese)
[4] 杨杨,戚艳杰,陈旭,等.父母养育方式和生活事件对儿童青少年情绪行为问题影响的调查[J].中华精神科杂志,2021,54(5): 374-380.
Yang Y, Qi YJ, Chen X, et al.A survey on the influence of parenting style and life events on emotional and behavioral problems in children and adolescents[J].Chin J Psychiatry, 2021,54(5): 374-380.(in Chinese).
[5] Vaezghasemi M, Pulkki-Brännström AM, Lindkvist M, et al.Social inequalities in social-emotional problems among preschool children: A population-based study in Sweden[J].Glob Health Action, 2023, 16(1): 2147294.
[6] UK Department of Health and Education.Special educational needs and disability code of practice: 0 to 25 years[M].UK: Goverment of UK, 2015.
[7] Gibney C.What is early childhood development? A guide to the science (ECD 1.0)[M].Harvard University: Center on the developing Child at Harvard University, 2019.
[8] Nadeau S, Hasan R.Early childhood development: A review of the global evidence[R/OL].The World Bank, 2015.https://doi.org/10.1596/23871.
[9] Petruccelli K, Davis J, Berman T.Adverse childhood experiences and associated health outcomes: A systematic review and meta-analysis[J].Child Abuse Negl, 2019, 97: 104127.
[10] Swift A, Berry M, Fernandez-Pineda M, et al.An integrative review of adverse childhood experiences and reproductive traumas of infertility and pregnancy loss[J].J Midwifery Women Health, 2024, 69(2): 258-278.
[11] 吴峻,李若瑜,万宇辉.炎症因子与母亲童年期不良经历和儿童青少年心理行为问题的关联性研究进展[J].广西医学,2024,46(7): 961-965.
Wu J, Li RY, Wan YH.Association of inflammatory factors with maternal adverse childhood experiences and psychological behavior problems in children and adolescents: A research progress[J].Guangxi Medical Journal, 2024,46(7): 961-965.(in Chinese)
[12] Wang S, Ding C, Dou C, et al.Associations between maternal prenatal depression and neonatal behavior and brain function - Evidence from the functional near-infrared spectroscopy[J].Psychoneuroendocrinology, 2022, 146: 105896.
[13] 徐玉英,郭晨名,梅方璇,等.家庭养育环境与幼儿社会情绪能力的相关研究[J].中国儿童保健杂志,2024,32(5): 559-565.
Xu YY, Guo CM, Mei FX, et al.Study on the correlation between home rearing environment and social emotional competence of infants and toddlers[J].Chin J Child Health Care, 2024,32(5): 559-565.(in Chinese)
[14] Jones BL, Nagin DS, Roeder K.A SAS procedure based on mixture models for estimating developmental trajectories[J].Sociol Method Res, 2001, 29(3): 374.
[15] Anda RF, Felitti VJ, Bremner JD, et al.The enduring effects of abuse and related adverse experiences in childhood.A convergence of evidence from neurobiology and epidemiology[J].Eur Arch Psychiatry Clin Neurosci, 2006, 256(3): 174-186.
[16] Oosterman M, Schuengel C, Forrer ML, et al.The impact of childhood trauma and psychophysiological reactivity on at-risk women′s adjustment to parenthood[J].Dev Psychopathol, 2019, 31(1): 127-141.
[17] Wajid A, van Zanten SV, Mughal MK, et al.Adversity in childhood and depression in pregnancy[J].Arch Womens Ment Health, 2020, 23(2): 169-180.
[18] Armans M, Addante S, Ciciolla L, et al.Resilience during pregnancy: How early life experiences are associated with pregnancy-specific stress[J].Adv Res Sci, 2020, 1(4): 295-305.
[19] Danese A, Moffitt TE, Harrington H, et al.Adverse childhood experiences and adult risk factors for age-related disease: Depression, inflammation, and clustering of metabolic risk markers[J].Arch Pediatr Adolesc Med, 2009, 163(12): 1135-1143.
[20] Treyvaud K, Anderson VA, Lee KJ, et al.Parental mental health and early social-emotional development of children born very preterm[J].J Pediatr Psychol, 2010, 35(7): 768-777.
[21] Wendland J, Benarous X, Young H, et al.Impact of the timing of maternal peripartum depression on infant social and emotional development at 18 months[J].J Clin Med, 2022, 11(23): 6919.
[22] Gerardin P, Wendland J, Bodeau N, et al.Depression during pregnancy: Is the developmental impact earlier in boys? A prospective case-control study[J].J Clin Psychiatry, 2011, 72(3): 378-387.
[23] Lupien SJ, McEwen BS, Gunnar MR, et al.Effects of stress throughout the lifespan on the brain, behaviour and cognition[J].Nat Rev Neurosci, 2009, 10(6): 434-445.
[24] Fitzgerald E, Parent C, Kee MZL, et al.Maternal distress and offspring neurodevelopment: Challenges and opportunities for pre-clinical research models[J].Front Hum Neurosci, 2021, 15: 635304.
[25] Briggs-Gowan MJ, Carter AS, Bosson-Heenan J, et al.Are infant-toddler social-emotional and behavioral problems transient?[J].J Am Acad Child Adolesc Psychiatry, 2006, 45(7): 849-858.
[26] Van den Bergh BRH, van den Heuvel MI, Lahti M, et al.Prenatal developmental origins of behavior and mental health: The influence of maternal stress in pregnancy[J].Neurosci Biobehav Rev, 2020, 117: 26-64.