Cumulative adversity, mindfulness, and mental health in first-time mothers experiencing low income

Abstract

Background: Socioeconomic adversity can negatively impact the mental and physical health of mothers and their offspring. This paper extends understanding of the interrelationship of these factors during the perinatal time frame, specifically to: 1.) evaluate the impact of adverse childhood events (ACES), negative life events (NLEs), and socioeconomic factors on the mental health of low-income expecting mothers; 2) evaluate for differences by race/ethnicity in adversity predicting perinatal mental health; 3) examine how mindfulness interacts with socioeconomic adversity in predicting prenatal mental health. Methods: 202 predominately non-white primiparous females with household income at or below 200% of the federal poverty level participated. Measures included ACEs, NLEs, and several descriptors of socioeconomic status. Resilience and mindfulness were measured as possible protective factors. In the sequence of socioeconomic factors, ACEs, and NLEs, hierarchical multiple regression tested these measures as predictors of prenatal depression and anxiety, also evaluating for interaction effects. Results: Controlling for socioeconomic factors, higher ACEs and NLEs independently predicted worse prenatal mental health. Cumulative socioeconomic risk interacted with ACEs to predict higher prenatal anxiety and more accurately predict prenatal depression scores. Higher mindfulness predicted lower anxiety and depression regardless of adversity, but was also significantly negatively correlated with ACEs. Limitations: Generalizability of results are limited by the sample size and specific geographic region. Conclusion: Socioeconomic and psychosocial adversity cumulatively impact prenatal mental health. Mindfulness may be a valuable target for resilience-enhancing interventions prepartum but is not a solution to the clear detriments that social and economic marginalization have on mental health.

Keywords

• Childhood adversity
• Prenatal mental health
• Poverty
• Mindfulness