Adverse Childhood Experiences and Adverse Community Environments Among Maternal Mortality Cases in Arizona

Kellerhals, Sarah; Suh, Bin; Celaya, Martín; Ramirez, Glenda M; Gray, Kendra

doi:10.1016/j.ajog.2022.11.415

Cited by 2 publications

(1 citation statement)

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“…Furthermore, female adults (as compared to males) have been reported in certain studies to be at increased mortality risk following physical (Chen et al, 2016;Wang et al, 2023), emotional abuse (Chen et al, 2016), sexual abuse (Wang et al, 2023) in childhood. A review by the American Maternal Mortality Review Community found increased rates of maternal death amongst those who had experienced ACEs including emotional, physical, or sexual abuse, and household dysfunction (Kellerhals et al, 2023). Mortality risk has been reported for both sexes in further studies, with females again reported as being at greater risk following specific ACEs; serious illness, war/natural disasters, and number of events (Johnson et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

Adverse Childhood Experiences and All-Cause Mortality Risk in Adulthood

D’Arcy-Bewick¹,

Turiano²,

Sutin³

et al. 2023

Preprint

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Background: Adverse Childhood Experiences (ACEs) have been associated with mortality risk in adulthood. It is unclear, however, whether ACEs perpetrated beyond parents may be associated with mortality risk, if the risk is accumulative or plateaus at a certain frequency, whether associations differ dependent on ACE types, whether types interact with one another, or if observed effects differ by sex. Objective: To examine associations between ACEs and mortality risk. Participants and Setting: 6319 participants (age range 25-74 years, mean [SD] 46.91 [12.95] years; 51.6% female) followed from 1995/96 to 2018 as part of the survey of Midlife Development in the United States.Methods: ACE variables were self-reported exposure to 20 ACE types from five categories: physical abuse, emotional abuse, socioeconomic disadvantage, adverse family structure, and poor health at age 16 years. Cox proportional hazards models were used to estimate mortality risk.Results: ACEs were accumulatively associated with increased mortality risk in adjusted models (HR = 1.033; p = <.001, 95% CI, 1.014-1.053). The association was linear. Only physical abuse (HR = 1.05; p = .024, 95% CI, 1.01 – 1.10) remained significantly predictive of increased mortality risk adjusting for other types. No interaction by sex or among ACE types was observed. Conclusions: ACEs may be cumulatively associated with increased mortality risk, such that each individual ACE increases risk. Physical abuse may be an important ACE type within a mortality risk context. Individual ACE types warrant further study as each type may have their own differential impact on mortality risk.

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