Abstract Body: Background: Maternal health is critical in the U.S., especially in Georgia, with the second-highest maternal mortality rate. Adverse Childhood Experiences (ACEs), including early life trauma such as abuse, neglect, and household dysfunction, have been associated with adverse cardiovascular and mental health outcomes in adulthood. This study examined the relationships among ACEs, blood pressure variability (BPV), and depression among pregnant women in Georgia.
Methods: This is a cross-sectional study (Dec 2024 – Jun 2025). Forty
-four pregnant women (43% Blacks, 41% Whites and 16% others) aged ≥18 years in their 2nd or 3rd trimester were recruited. Validated questionnaires assessing ACEs, depressive symptoms, and general self-efficacy (GSE) were collected. ACEs were measured using 28 items, and categorized into four classes. BPV was evaluated using the average real variability (ARV) of SBP and DBP. Associations were examined using linear regression models, adjusting for covariates including maternal age, gestational week, socioeconomic status (SES), race, and body mass index (BMI).
Results: Over 36% of participants had elevated BP (≥120/80 mmHg). Over 40% had moderate and severe ACE scores, and about 32% had moderate or severe depression (14-30). There was no significant correlation between ACE scores and SBP or DBP. However, severe ACEs appeared to be positively correlated with SBPV (β = 2.1, p = 0.058). Higher ACE scores were significantly associated with moderate (β = 0.51, p = 0.041), and higher depression (β = 0.40, 95% CI 0.06 to 0.75, p = 0.024) scores after adjusting for age, gestational age in weeks, race, SES and BMI. Having severe ACE scores, depression scores increased by 49.2%, after controlling for covariates. Lower general self-efficacy (GSE) score was significantly associated with higher depression scores (β = –3.59, p = 0.001).
Conclusion: Greater exposures to ACEs and lower self-efficacy are significantly associated with greater depressive symptoms during pregnancy, suggesting that early life adversity may have lasting effects on mental health during pregnancy. Findings aligned with prior studies show that childhood adversity increases adult mental health risk, but self-efficacy buffers against stress. Moreover, the trend toward higher ACE scores being associated with higher SBPV warrants further investigation in larger studies.