MATERNAL TRAUMA AFFECTS PRENATAL MENTAL HEALTH AND INFANT STRESS REGULATION AMONG PALESTINIAN DYADS

ABSTRACT We examined how diverse and cumulated traumatic experiences predicted maternal prenatal mental health and infant stress regulation in war conditions and whether maternal mental health mediated the association between trauma and infant stress regulation. Participants were 511 Palestinian mothers from the Gaza Strip who reported exposure to current war trauma (WT), past childhood emotional (CEA) and physical abuse, socioeconomic status (SES), prenatal mental health problems (posttraumatic stress disorder and depression symptoms), and perceived stress during their secondtrimester of pregnancy as well as infant stress regulation at 4 months. While all trauma types were associated with high levels of prenatal symptoms, CEA had the most wide‐ranging effects and was uniquely associated with depression symptoms. Concerning infant stress regulation, mothers’ CEA predicted negative affectivity, but only among mothers with low WT. Against hypothesis, the effects of maternal trauma on infant stress regulation were not mediated by mental health symptoms. Mothers’ higher SES was associated with better infant stress regulation whereas infant prematurity and male sex predisposed for difficulties. Our findings suggest that maternal childhood abuse, especially CEA, should be a central treatment target among war‐exposed families. Cumulated psychosocial stressors might increase the risk for transgenerational problems. RESUMEN Examinamos hasta qué punto las diversas y acumuladas experiencias traumáticas predecían la salud mental materna prenatal y la regulación del estrés del infante en condiciones de guerra y si la salud mental materna mediaba la asociación entre el trauma y la regulación del estrés del infante. Las participantes fueron 511 madres palestinas del Área de Gaza quienes reportaron el haber estado expuestas al trauma de la presente guerra (WT), pasado abuso emocional (CEA) y físico (CPA) en la niñez, la condición socio‐económica (SES), problemas de salud mental prenatales (trastorno de estrés postraumático [PTSD] y síntomas de depresión), y el estrés percibido durante su segundo trimestre de embarazo (T1), así como la regulación del estrés del infante a los cuatro meses (T2). Mientras que todos los tipos de trauma se asociaron con altos niveles de síntomas prenatales, CEA presentó los efectos más amplios y de manera única se asoció con síntomas de depresión. Con respecto a la regulación del estrés del infante, el CEA de las madres predijo una afectividad