Adverse childhood experiences and lifetime adverse maternal outcomes (gestational diabetes and hypertensive disorders of pregnancy) in the Hispanic Community Health Study/Study of Latinos

Stanhope, Kaitlyn K; Cammack, Alison L.; Perreira, Krista M.; Fernández-Rhodes, Lindsay; Cordero, Christina; Gallo, Linda C.; Isasi, Carmen R.; Castañeda, Sheila F.; Daviglus, Martha L.; Kominiarek, Michelle A.; Suglia, Shakira F.

doi:10.1016/j.annepidem.2020.08.004

Cited by 14 publications

(14 citation statements)

References 37 publications

(51 reference statements)

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“…15 Prior studies (Appendix 1, available online at http://links.lww.com/AOG/C460) that have examined this relationship are limited by small sample sizes, 13 populations with limited generalizability, 16,17 or significant concern for confounding bias. [18][19][20] To fill this evidence gap, our objective was to examine the association between adverse childhood experiences and adverse perinatal outcomes using a diverse sample of individuals with perinatal mental health conditions. We hypothesized that having a high ACE (adverse childhood experience) score would be associated with an increased prevalence of adverse pregnancy outcomes.…”

mentioning

confidence: 99%

Association Between Adverse Childhood Experiences and Adverse Pregnancy Outcomes

Fleming

Ekpe

Grobman

et al. 2021

Obstetrics &Amp; Gynecology

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OBJECTIVE: To examine the association between adverse childhood experiences and adverse pregnancy outcomes. METHODS: This cohort study included individuals who enrolled in a perinatal collaborative mental health care program (COMPASS [the Collaborative Care Model for Perinatal Depression Support Services]) between 2017 and 2021. Participants completed psychosocial self-assessments, including an adverse childhood experiences screen. The primary exposure was adverse childhood experiences measured by the ACE (adverse childhood experience) score, which was evaluated as a dichotomized variable, with a high ACE score defined as greater than three. Secondary analyses used the ACE score as a continuous variable. Adverse pregnancy outcomes including gestational diabetes, hypertensive disorders of pregnancy, preterm birth, and small-for-gestational-age (SGA) births were abstracted from the electronic health record. Bivariable and multivariable analyses were performed, including mediation analyses. RESULTS: Of the 1,274 women with a completed adverse childhood experiences screen, 904 (71%) reported one or more adverse childhood experiences, and 290 (23%) reported a high ACE score (more than three adverse childhood experiences). Adverse childhood experience scores were not associated with gestational diabetes or SGA births. After controlling for potential confounders, individuals with high ACE score had 1.55-fold (95% CI 1.06–2.26) increased odds of having hypertensive disorders of pregnancy and 2.03-fold (95% CI 1.38–2.99) increased odds of preterm birth. Each point increase in ACE score was not associated with a statistically increased odds of hypertensive disorders of pregnancy (adjusted odds ratio [aOR] 1.07, 95% CI 0.99–1.15); however, each additional point on the adverse childhood experiences screen was associated with increased odds of preterm birth (aOR 1.13, 95% CI 1.05–1.22). Mediation analyses demonstrated tobacco use, chronic medical problems, and obesity each partially mediated the observed association between high ACE scores and hypertensive disorders of pregnancy. Having chronic medical comorbidities partially mediated the observed association between high ACE scores and preterm birth. CONCLUSION: One in four individuals referred to a perinatal mental health program who were pregnant or postpartum had a high ACE score. Having a high ACE score was associated with an increased risk of hypertensive disorders of pregnancy and preterm birth. These results underscore how remote events may reverberate through the life course.

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confidence: 99%

Association Between Adverse Childhood Experiences and Adverse Pregnancy Outcomes

Fleming

Ekpe

Grobman

et al. 2021

Obstetrics &Amp; Gynecology

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“…These studies are also limited by small sample sizes, with childhood adversity measured through retrospective reporting of adversities that is prone to recall bias. [10][11][12] Research reporting an association found that those who experienced childhood physical or sexual abuse had the greatest risk of developing GDM, with several other adversity types left unaccounted for. 13,14 Other adversities occurring in childhood have previously been found to affect health outcomes including type 2 diabetes, 15 and studies show that family and social adversity are highly entangled and cannot be understood independently of each other.…”

Section: Introductionmentioning

confidence: 99%

“…Recent research has identified a link between childhood adversity and the risk of developing GDM, though studies are few and report mixed findings. These studies are also limited by small sample sizes, with childhood adversity measured through retrospective reporting of adversities that is prone to recall bias 10–12 . Research reporting an association found that those who experienced childhood physical or sexual abuse had the greatest risk of developing GDM, with several other adversity types left unaccounted for 13,14 .…”

Section: Introductionmentioning

confidence: 99%

Childhood adversity and the risk of gestational diabetes: A population‐based cohort study of nulliparous pregnant women

Davies,

van Houten,

Bengtsson

et al. 2023

Diabet Med

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AimsGestational diabetes mellitus (GDM) is one of the most common pregnancy complications, and though it may be linked to childhood adversity, the effect of different types of adversity remains unclear. Childhood adversity is linked to a younger maternal age, which may hide the overall impact of adversity on GDM risk. We therefore aimed to explore the association between different types of childhood adversity and GDM while accounting for the potential impact of maternal age.MethodsWe used Danish nation‐wide register data, including 208,207 women giving birth for the first time from 2004 to 2018. Five adversity groups were used to examine the effect of childhood adversity on GDM risk: (1) low (referent group), (2) early life material deprivation, (3) persistent deprivation, (4) loss or threat of loss within the family and (5) high adversity.Results5375 women were diagnosed with GDM in the study population (2.6% absolute risk). Compared to women who experienced low adversity, the other adversity groups had a higher GDM risk (absolute difference [%]) directly; early material deprivation (0.64% [95% CI 0.44; 0.84]), persistent deprivation (0.63% [0.41; 0.86]), loss or threat of loss (0.73% [0.42; 1.05]) and high adversity (0.80% [0.32; 1.27]). The indirect effect of maternal age attenuated the total effect of childhood adversity on GDM by an absolute difference of 0.25%–0.46%.ConclusionsExperiencing childhood adversity to any extent is associated with a higher risk of GDM. Interventions aimed at preventing childhood adversity may have a positive effect in reducing GDM burden and the associated health risks.

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Section: Introductionmentioning

confidence: 99%

“…As pregnancy is a natural stress test for the future development of chronic disease, groups at high risk of diabetes, that is, women with multiple ACEs, are more likely to develop HIP. [6,7] Poor parent-daughter relationships can be one phenotype of ACEs, as poor parent-child relationships were also associated with youth smoking, unhealthy weight control behavior, obesity, and psychological distress in adulthood [8][9][10]. Thus, the pregnant women's relationship with their parents may be associated with HIP risk.…”

Section: Introductionmentioning

confidence: 99%

Association between poor parent-daughter relationships and the risk of hyperglycemia in pregnancy: a hospital-based prospective cohort study in Japan

Maeda

Doi

Isumi

et al. 2023

BMC Pregnancy Childbirth

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Background Adverse child experiences (ACEs), childhood maltreatment and household dysfunction, are risk factors of hyperglycemia in pregnancy (HIP), including diabetes before pregnancy, gestational diabetes (GDM), and overt diabetes in pregnancy, through increased risk of unhealthy behaviors, obesity, and stress response system dysfunction. While ACEs are often difficult to be assessed in hospital settings, parent-daughter relationship, that is, pregnant women’s relationship with their parents can be considered as a measurable maker for ACEs that may be associated with HIP. The purpose of this study is to examine the association between poor parent-daughter relationship and HIP. Methods Hospital-based prospective cohort study was conducted in Japan (N = 6,264). Women visiting participating 58 facilities for delivery between April 2019 and March 2020 were included. Parent-daughter relationship was assessed by a questionnaire asking whether participants were satisfied with their relationship with their parents. HIP was diagnosed based on the criteria used in Japan. A multiple logistic regression model was applied to adjust for covariates. Results Pregnant women who were not very satisfied and not satisfied at all with the relationship with their parents, and HIP were 343 (5.5%), 74 (1.2%), and 274 (4.4%), respectively. Pregnant women who were not very satisfied with their parent-daughter relationship showed a significant positive association with HIP in the crude model (odds ratio (OR): 1.71, 95% confidence interval (CI): 1.11–2.63). When stratified by psychiatric disease history, we found a significant positive association among those without psychiatric disease history (OR: 1.77, 95% CI: 1.11–2.84), but not among those with psychiatric disease history (OR: 0.61, 95% CI: 0.16–2.28). Conclusions Poor parent-daughter relationship was associated with the risk of HIP among pregnant women without psychiatric disease history, suggesting that this simple question could be used to estimate the risk of HIP when it was challenging to inquire directly about ACEs. Further research is needed to elucidate the mechanism of the association.

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Adverse childhood experiences and lifetime adverse maternal outcomes (gestational diabetes and hypertensive disorders of pregnancy) in the Hispanic Community Health Study/Study of Latinos

Abstract: Purpose: Childhood adversity is associated with increased risk of adult disease, including type 2 diabetes and hypertension. However, little is known about potential associations between childhood adversity and adverse pregnancy outcomes. The goal of this study is to examine the

Cited by 14 publications

References 37 publications

Association Between Adverse Childhood Experiences and Adverse Pregnancy Outcomes

Association Between Adverse Childhood Experiences and Adverse Pregnancy Outcomes

Childhood adversity and the risk of gestational diabetes: A population‐based cohort study of nulliparous pregnant women

Association between poor parent-daughter relationships and the risk of hyperglycemia in pregnancy: a hospital-based prospective cohort study in Japan

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