Adverse childhood experiences and poor birth outcomes in a diverse, low-income sample

Abstract

BackgroundAdverse childhood experiences (ACE) are associated with an array of health consequences in later life, but few studies have examined the effects of ACEs on women’s birth outcomes.MethodsWe analyzed data gathered from a sample of 1848 low-income women who received services from home visiting programs in Wisconsin. Archival program records from a public health database were used to create three birth outcomes reflecting each participant’s reproductive health history: any pregnancy loss; any preterm birth; any low birthweight. Multivariate logistic regressions were performed to test the linear and non-linear effects of ACEs on birth outcomes, controlling for age, race/ethnicity, and education.ResultsDescriptive analyses showed that 84.4% of women had at least one ACE, and that 68.2% reported multiple ACEs. Multivariate logistic regression analyses showed that cumulative ACE scores were associated with an increased likelihood of pregnancy loss (OR = 1.12; 95% CI = 1.08–1.17), preterm birth (OR = 1.07; 95% CI = 1.01–1.12), and low birthweight (OR = 1.08; 95% CI = 1.03–1.15). Additional analyses revealed that the ACE-birthweight association deviated from a linear, dose-response pattern.ConclusionsFindings confirmed that high levels of childhood adversity are associated with poor birth outcomes. Alongside additive risk models, future ACE research should test interactive risk models and causal mechanisms through which childhood adversity compromises reproductive health.

Associations between Adverse Childhood Experiences and Sexual Risk among Postpartum Women

“…Our study contributes to the growing evidence base linking ACE exposure with adverse health outcomes among perinatal populations. A growing number of researchers have applied a life-course perspective to the study of maternal and child health [ 6 , 51 ], due, in part, to increased recognition of the intergenerational transmission of maternal adversity and its sequelae. Greater understanding of the risks that ACE exposure poses both to adversity-exposed women and their infants is critical for appropriate assessment and intervention efforts to improve maternal and child health.…”

“…Women exposed to ACEs are over-represented among those who have adverse birth outcomes, including miscarriage [ 3 , 4 ], shortened gestational period and low birthweight [ 5 , 6 ]. They also are at increased risk for perinatal depression and anxiety [ 7 , 8 ] as well as other chronic health conditions [ 9 ].…”

Adverse Childhood Experiences are Associated with illicit drug use among pregnant women with middle to high socioeconomic status: Findings from the All Our Families Cohort

“…Within low socioeconomic samples, adverse childhood experiences (ACEs), de ned as child maltreatment and exposure to household dysfunction before 18 years of age, are strongly associated with illicit drug use in pregnancy, as well poor birth outcomes more generally. 28,29 For example, a study of single, low income, African American women found the association between having three or more ACEs and illicit drug use in pregnancy was strong (OR of 6) and dose-dependent. 24 While it is often assumed that the impact of ACEs on illicit drug use is reduced among pregnant women with average to high socioeconomic status, this assumption is not well tested in the scienti c literature.…”

Racial Disparities in Mental Health Outcomes Among Women With Early Pregnancy Loss

“… 9 , 12 – 16 Other variables, such as stress and adverse childhood experiences, may mediate some of these associations, because they are also more prevalent among Black people when compared with other racial groups. 17 – 23 Higher adverse childhood experience scores are associated with a greater likelihood of pregnancy loss, preterm birth, and perinatal depression, 24 – 26 but the relationship between race, adverse childhood experience, and pregnancy-related morbidity has only recently been explored. 24 , 27 …”

“…17 – 23 Higher adverse childhood experience scores are associated with a greater likelihood of pregnancy loss, preterm birth, and perinatal depression, 24 – 26 but the relationship between race, adverse childhood experience, and pregnancy-related morbidity has only recently been explored. 24 , 27 …”