Background <p>Prenatal depression is a significant public health concern that affects both mothers and their infants. Self-efficacy has been identified as a protective factor against prenatal depression; however, the longitudinal dynamics between these constructs, particularly concerning adverse childhood experiences, remain underexplored.</p> Methods <p>This study utilized a prospective cohort design involving 721 pregnant women from the Be Resilient to Postpartum Depression study in China. Assessments were conducted during the first (T1), second (T2), and third trimesters (T3) from January 2022 to August 2022. Data were collected using the Adverse Childhood Experience scale, the General Self-Efficacy Scale, and the Hospital Anxiety and Depression Scale. Data analysis was conducted using parallel latent growth curve models.</p> Results <p>The findings indicated a significant correlation between baseline self-efficacy and baseline prenatal depression levels (<i>β</i>=-0.267, <i>P</i> &lt; 0.01). Additionally, the change rate of self-efficacy was strongly associated with the change rate of prenatal depression (<i>β</i>=-0.434, <i>P</i> &lt; 0.01). Notably, baseline prenatal depression significantly predicted the change rate of self-efficacy (<i>β</i> = 0.115, <i>P</i> = 0.034). In the multigroup parallel latent growth curve models, the change rate of prenatal depression levels was associated with the change rate of self-efficacy (<i>β</i>=-0.424, <i>P</i> &lt; 0.01) and was predicted by baseline self-efficacy levels (<i>β</i>=-0.023, <i>P</i> = 0.031) in the group without adverse childhood experiences. Conversely, within the adverse childhood experiences group, baseline prenatal depression levels significantly predicted the change rate of self-efficacy (<i>β</i> = 0.227, <i>P</i> = 0.049).</p> Conclusion <p>Enhancing self-efficacy may mitigate the impact of prenatal depression, particularly among women with adverse childhood experiences.</p>