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2019 HSR&D/QUERI National Conference Abstract

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4079 — A Longitudinal Investigation of Military Sexual Trauma and Perinatal Depression

Lead/Presenter: Georgina Gross,  COIN - West Haven
All Authors: Gross GM (VA Connecticut Healthcare System, Pain Research, Informatics, Multimorbidities, and Education (PRIME) HSR&D Center of Innovation), Kroll-Desrosiers, A (Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA), Mattocks, K (Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA; VA Central Western Massachusetts Healthcare System, Leeds, MA)

Objectives:
Military sexual trauma (MST) is highly prevalent among women Veterans and associated with numerous detrimental mental health outcomes including depression and risk for suicide. Women are one of the fastest growing segments of Veterans, which has increased the need for reproductive health care services. However, little is known about women Veterans' perinatal mental health, particularly regarding the impact of MST on pregnancy and post-delivery mental health outcomes. The purpose of the present study was to examine the association between MST and perinatal depression and suicidal ideation (SI).

Methods:
Longitudinal associations and Hayes mediation models were conducted using interview data from the ongoing Center for Maternal and Infant Outcomes Research in Translation (COMFORT) study. COMFORT includes 620 Veterans interviewed during pregnancy, 443 of whom have been re-interviewed after delivery.

Results:
Women who experienced MST (harassment and assault) reported higher pre and postnatal symptoms of depression and SI. Further, prenatal depression mediated the association between MST and postnatal depression (indirect effect [standard error] of harassment on postnatal depression through prenatal depression: 1.11 [0.26], p < .001; indirect effect [standard error] of assault on postnatal depression through prenatal depression: 1.50 [0.35] p < .001), even after controlling for demographic variables and prenatal stress.

Implications:
Findings suggest that MST is a risk factor for post-deployment depression and SI during pregnancy and following delivery. Further, targeting depression during the prenatal period may lead to subsequent reductions in postnatal depression for women Veterans who have experienced MST.

Impacts:
This is the first study to investigate the impact of MST on risk for depression and SI during and after pregnancy. Findings highlight the importance of screening and treatment for trauma-related mental health symptoms among pregnant Veterans to mitigate trajectories of risk following MST.