Associations Among Child Abuse, Depression, and Interleukin-6 in Pregnant Adolescents: Paradoxical Findings

Abstract

Objective Limited data exist on child abuse-related immune variation during pregnancy, despite implications for maternal and infant health and extensive data showing that abuse history and depression are related to increased inflammation in other populations. This study examined associations among child abuse, depression, circulating levels of inflammatory markers, and perinatal health in pregnant adolescents, a group at high risk for childhood abuse and poor birth outcomes. Methods Pregnant teenagers (n=133; 14–19 years; 89.5% Latina) reported on abuse and depression and had two blood draws (24–27 and 34–37 gestational weeks, 2nd and 3rd trimesters, respectively) for Interleukin 6 (IL-6) and C-Reactive Protein (CRP); birth outcomes were collected. Results Abuse and depression interacted to predict higher IL-6 at 2nd trimester (B=.006, p=0.011) such that severely abused adolescents with high depression had higher IL-6 relative to severely abused adolescents with low depression; depression did not differentiate IL-6 levels for those with low abuse severity. Abuse and IL-6 also interacted to predict gestational age at birth (B=.004, p=0.040) such that those with low abuse and high IL-6 and those with high abuse and low IL-6 had infants with earlier gestational age at birth. Cortisol at the 2nd trimester mediated the association between IL-6 and gestational age at birth (Indirect effect estimate=−0.143, p<0.039). Conclusion Depression severity distinguished IL-6 levels among more severely abused pregnant Latina adolescents, but it was unrelated to IL-6 among less severely abused adolescents. Cortisol explained the relationship between IL-6 and earlier gestational age at birth. Multiple adversities and inflammation may influence birth outcomes and potentially affect intergenerational health.

Pathways linking childhood abuse history and current socioeconomic status to inflammation during pregnancy

“…Consistent with the larger literature (Miller et al, 2017; Mitchell et al, 2018; Walsh et al, 2016), the current study provides further evidence that adversities experienced during childhood and adulthood are associated with elevated inflammatory markers during pregnancy. Specifically, bivariate correlations revealed that a history of childhood abuse was positively associated with both CRP and IL-6 in a sample of pregnant women, while current SES was negatively associated with both CRP and IL-6.…”

Childhood Sexual Abuse and Indicators of Immune Activity: A Systematic Review

“…The articles presented in this review evaluated sexual abuse as an independent variable alone or a subtype of childhood maltreatment (CM), in this case the authors investigated other types of abuse besides CSA, making correlations between the inflammatory markers and each type of abuse, including CSA. Only two studies evaluated exclusively CSA ( 37 , 48 ), other two data investigated physical and sexual abuse ( 38 , 51 ), the remain 13 studies evaluated all subtypes of maltreatment and the correlation of each subtype, and CM global scores, to immune system alterations ( 39 – 47 , 49 , 50 , 52 , 53 ).…”

“…Nine studies ( 39 , 40 , 42 , 44 – 47 , 52 , 53 ) used the Childhood Trauma Questionnaire (CTQ), a self-applicable instrument used for assessing physical, emotional, sexual abuses as well as physical and emotional negligence ( 54 ). The items are added up so that the five different subtypes of abuse score differently.…”

“…Walsh et al evaluated 133 pregnant teenagers with sexual abuse history on their second and third trimesters. Adolescents with history of more severe abuse and depression had higher IL-6 levels in the second trimester compared to those with less severe abuse and milder depression ( 52 ). Bertone-Johnson et al investigated IL-6 levels in 702 participants of the Nurses' Health Study II, of whom 228 had a child sexual abuse history.…”

Intergenerational transmission of depression: clinical observations and molecular mechanisms

“…Indeed, one study has shown that regulatory T-cells are significantly increased in both the prenatal and postnatal period in mothers suffering depression 190 . Another study has shown that experience of abuse may be the key moderator of this relationship, as experience of abuse and depression in pregnant adolescents predicts higher IL-6 concentration during pregnancy, but none such association in absence of exposure to abuse 203 . However, other studies investigating cytokine levels have shown that depressive symptoms during pregnancy are negatively correlated with cytokines such as IL-1β, Il-7 and TNFa 204,205 .…”