This was a retrospective cohort study of pregnant individuals in the Kaiser Permanente Northern California system who were screened for adverse childhood experiences and resilience as part of standard prenatal care at about 16 weeks of gestation. Overall, 14,625 pregnancies were included; 17.0% had newly identified depression; 9.8% had newly identified depression symptoms; and 8.9% had newly identified anxiety during the pregnancy with no known preexisting diagnosis. We found that adverse childhood experiences and low resilience were independently associated with newly identified depressive disorders, depression symptoms, and anxiety disorders during pregnancy. When adverse childhood experiences and resilience were modeled in combination, the greatest odds of each outcome occurred in individuals with a combination of four or more adverse childhood experiences and low resilience (vs no adverse childhood experiences and high resilience): depression adjusted odds ratio (aOR) 6.43 (95% CI, 5.23-7.90), depression symptoms aOR 9.49 (95% CI, 7.50-12.0), and anxiety disorder aOR 4.79 (95% CI, 3.81-6.02). Routine screening for adverse childhood experiences and resilience may identify individuals at risk of developing prenatal depression and anxiety, allowing faster resource linkage and potentially improved maternal and child outcomes.

中文翻译：

---

不良童年经历和复原力与怀孕期间抑郁和焦虑的关联。

这是一项针对北加州 Kaiser Permanente 系统中孕妇的回顾性队列研究，这些孕妇在妊娠 16 周左右时接受了不良童年经历和心理弹性筛查，作为标准产前护理的一部分。总共包括 14,625 例怀孕；17.0% 患有新发现的抑郁症；9.8%有新发现的抑郁症状；8.9% 的人在怀孕期间新发现焦虑症，但之前没有已知的诊断。我们发现，不良的童年经历和低复原力与新发现的妊娠期抑郁症、抑郁症状和焦虑症独立相关。当不良童年经历和复原力结合建模时，每种结果的最大几率发生在具有四种或更多不良童年经历和低复原力组合的个体中（与没有不良童年经历和高复原力相比）：抑郁调整优势比（aOR ) 6.43 (95% CI, 5.23-7.90)，抑郁症状 aOR 9.49 (95% CI, 7.50-12.0)，焦虑症 aOR 4.79 (95% CI, 3.81-6.02)。对不良童年经历和复原力进行常规筛查可能会识别出有患产前抑郁和焦虑风险的个体，从而实现更快的资源链接并可能改善孕产妇和儿童的结局。