Exploring the Association Between Childhood Emotional Maltreatment and Eating Disorder Symptoms During Pregnancy: A Moderated Mediation Model with Prenatal Emotional Distress and Social Support.

Background/objectives: Pregnancy is a critical period marked by significant transformations that can trigger or exacerbate eating disorder symptoms. Childhood emotional maltreatment, including abuse and neglect, is a known risk factor for disordered eating, yet its specific impact during pregnancy remains unexplored. For this reason, this study aimed to examine the link between childhood emotional maltreatment and eating disorder symptoms in pregnant women, also focusing on the potential mediating and moderating variables involved in this association. Specifically, this study explored the mediating role of prenatal emotional distress, whereas prenatal social support was investigated as a protective factor able to moderate the effects of past trauma on disordered eating during this sensitive period.

Methods: Participants were 272 Italian pregnant women (aged 18-48, = 31.21, = 4.95) who were asked to respond to four self-report instruments: Childhood Trauma Questionnaire-Short Form; Eating Disorder Examination-Questionnaire Short; Perinatal Assessment of Maternal Affectivity; and Maternity Social Support Scale.

Results And Conclusions: The results showed that prenatal emotional distress totally mediated the association between childhood emotional maltreatment and eating disorder symptoms in pregnant women ( = 0.20; SE = 0.06; 95% CI: 0.08, 0.33; < 0.001). Moreover, moderation analysis showed that prenatal social support only moderated the direct link between childhood emotional maltreatment and disordered eating, so higher levels of childhood emotional maltreatment were predictive of higher levels of eating disorder symptoms only among pregnant women with low levels of prenatal social support ( = 0.17; SE = 0.06; = 2.73; 95% CI: 0.05, 0.30; < 0.01). The limitations and clinical implications are discussed.