Childhood maltreatment as a risk factor for depressive symptoms after an unintended pregnancy: The role of emotion regulation difficulties

• More depressive symptoms in maltreatment exposed after unintended pregnancy • More emotion regulation difficulties in maltreatment exposed • Significant contribution of emotion regulation to depression, beyond childhood maltreatment. Individuals who experience an unintended pregnancy are at risk of developing depressive symptoms, regardless of whether the pregnancy is terminated or carried to term. Knowledge about particularly vulnerable individuals after an unintended pregnancy and about potential mechanisms of change is scarce. This study investigated whether participants with childhood maltreatment after an unintended pregnancy (abortion or delivery), and whether difficulties in emotion regulation contribute significantly to depressive symptoms, beyond the effects of childhood maltreatment. Welch t-tests, chi-square-tests and hierarchical regression analysis were conducted. We included 190 participants, 46.8% of whom had experienced childhood maltreatment. Participants with childhood maltreatment reported greater depressive symptoms (t=4.23, df=186, p <0.001) and were more likely to fulfill the diagnostic criteria for a depressive episode with onset during or after the pregnancy (χ²=6.5354, df=1, p < 0.05). The unique contribution of childhood maltreatment to depressive symptoms was 7% (F(184,1) = 21.52, p < .001), the unique contribution of difficulties in emotion regulation to depressive symptoms was 28% (F(183,1) = 80.70, p < .001). Limitations include the cross-sectional design and self-selected sample. Furthermore, only participants with unintended pregnancies were included, impeding comparisons with intended pregnancies. Individuals with childhood maltreatment are specifically vulnerable to developing depressive symptoms after an unintended pregnancy. Preventive interventions should identify these individuals and provide individualized support as early as possible. Emotion regulation may be a promising intervention target for reducing depressive symptoms after an unintended pregnancy.