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Poster Session 3

Category: Perinatal Mental Health

Poster Session 3

(919) Adverse Childhood Experiences and Maternal Infant Bonding in a High-Risk Obstetrics Population

Thursday, February 12, 2026

10:30 AM - 12:00 PM

Submitting Author and Presenting Author(s)

Rachel L. Wiley, MD, MPH (she/her/hers)

Maternal Fetal Medicine Fellow
Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego
San Diego, California, United States

Coauthor(s)

Dana R. Canfield, MD

Maternal Fetal Medicine Fellow
Department of Obstetrics & Gynecology , University of Washington, Seattle, WA
Seattle, Washington, United States
Emmanuel O. Elijah, MD (he/him/his)

Resident
Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego
San Diego, California, United States
Cynthia Gyamfi-Bannerman, MD, MS (she/her/hers)

Professor and Chair
Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego
San Diego, California, United States
Minhazur R. Sarker, MD

Fellow Physician
Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego
San Diego, California, United States
MJ

Marni B. Jacobs, PhD

Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego
San Diego, California, United States

Objective:
Maternal adverse childhood experiences (ACE) are increasingly recognized to have significant impact on parenting outcomes. This study examines the association between maternal ACEs and early maternal infant bonding in a high-risk obstetric population.

Study Design:
This is a secondary analysis of prospective cohort of patients recruited from the MFM practice at a single center. Participants were enrolled in the third trimester and followed longitudinally with surveys on health and birth experiences. At enrollment, participants completed the ACE questionnaire and were categorized into exposure groups: low (ACE = 0), moderate (ACE 1-3), and high (ACE > 4) exposure. At six weeks postpartum, participants completed perinatal mental health scales including Edinburg Postnatal Depression Scale (EPDS, positive considered > 10), Generalized Anxiety Disorder-7 (GAD-7, positive considered > 4), and the Mother-Infant Bonding (MIB) Scale, for which a score > 3 indicates impaired bonding.

Results:
Of 198 enrolled participants, 119 (60.1%) completed both the ACE and MIB scales and were included in the analysis. Of these, 31 (26.1%) were low, 64 (53.8%) were moderate, and 24 (20.2%) were high ACE exposure. Higher ACE exposure group was significantly associated with a history of a mental health diagnosis, and lower household income (all p <u>≤ 0.01, Table 1). Rates of impaired bonding were 19.4% (low), 29.7% (moderate), and 37.5% (high), which was not significantly different between groups (p = 0.24). Rates of positive postpartum mental health screen were significantly different (p < 0.01).

Conclusion:
In our high-risk population, maternal ACEs were not associated with impaired early infant bonding, but were associated with a positive postpartum mental health screen. This is particularly relevant for high risk populations, where both ACEs and perinatal mental health problems are prevalent. This adds to the developing literature that while maternal ACES are associated with perinatal psychopathology, they may not directly be associated with early adverse childhood outcomes.