Family-Level Mediators in the Intergenerational Transmission of Maternal Childhood Trauma: Systematic Review and Meta-Analysis of Pooled Effect Measures

Children of mothers with childhood trauma are at an increased risk for mental health problems, yet the most influential family-related mediators of this intergenerational transmission remain unclear. This systematic review and meta-analysis synthesized effect sizes from 29 studies (n = 352,279 dyads) examining psychosocial family-level mediators between maternal childhood trauma and child mental health. We identified 380 simple and 40 serial mediation paths across four domains: child characteristics, maternal characteristics, parent-child relationship factors, and household characteristics. Maternal characteristics showed the largest pooled effects (proportion median [PM]: 31.2%; ratio median [RM]: 0.21), particularly maternal mental health (PM: 36.0%), maternal attachment style (PM: 27.2%), and maternal social support (PM: 27.2%). Our findings highlight the potential central role of maternal factors in the intergenerational transmission of trauma. Interventions that bolster maternal mental health and social support would be most impactful in disrupting the intergenerational transmission of trauma, though further research is needed.