Promising Practices for Implementing Adverse Childhood Experiences and Resilience Screening in Obstetric Care

Watson, Carey; Kathryn, Ridout K; Nancy, Goler; Kelly, Young-Wolff C

doi:10.1089/jwh.2022.0260

Cited by 3 publications

(4 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…One means may be using clinical screenings during prenatal care and primary care visits to better detect the presence of ACEs and, when detected, provide trauma-informed care to help ensure a healthy pregnancy. For instance, recent evidence from two pilot studies in the Kaiser-Permanente system 35 found ACEs screenings can be feasibly conducted in a prenatal care setting without retraumatization, 36 and such practices can improve women's health outcomes and children. Therefore, assessing the feasibility of such approaches to mitigate prescription opioid use during pregnancy is an important area for future research to consider carefully.…”

Section: Discussionmentioning

confidence: 99%

Adverse Childhood Experiences and Prescription Opioid Use During Pregnancy: An Analysis of the North and South Dakota PRAMS, 2019-2020

Testa

Jacobs

Zhang

et al. 2023

Preprint

View full text Add to dashboard Cite

Objectives: This study assesses the association between adverse childhood experiences (ACEs) and prescription opioid use during pregnancy. Methods: This study uses data on 2,999 individuals from the 2019 and 2020 Pregnancy Risk Assessment Monitoring System (PRAMS) from North Dakota and South Dakota. The relationship between ACEs and prescription opioid use during pregnancy is examined using multiple logistic regression. Results: The prevalence of prescription opioid use increases alongside accumulating ACEs. Compared to those with no ACEs, recent mothers with three or more ACEs have a 2.4 greater odds of prescription opioid use during pregnancy (aOR [adjusted odds ratio] = 2.437; 95% CI [confidence interval] = 1.319, 4.503). Conclusion: Accumulating ACEs are associated with an increased risk of prescription opioid use during pregnancy. Additional research is needed better understand the mechanisms that link ACEs and prescription opioid use during pregnancy, as well as how to best support those with ACEs exposure in a trauma-informed manner to reduce the risk of substance use.

show abstract

Section: Discussionmentioning

confidence: 99%

Adverse Childhood Experiences and Prescription Opioid Use During Pregnancy: An Analysis of the North and South Dakota PRAMS, 2019-2020

Testa

Jacobs

Zhang

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…Findings from this study suggest that specific ACEs, including experiencing emotional abuse and having a parent in jail or prison, are particularly important predictors of mental/behavioral health conditions in pregnancy. Future studies are needed to continue to identify best practices for screening and recording maternal ACEs [ 64 ], and clinical perinatal settings may consider recording both the overall number of maternal ACEs, alongside individual ACE responses.…”

Section: Discussionmentioning

confidence: 99%

“…One element of trauma-informed involves screening for ACEs during prenatal care [ 27 , 70 ]. Based on patient feedback, this screening should be conducted with provider empathy [ 64 ] and in a private exam room [ 60 ] by either a physician or midwife [ 60 ] or behavioral health counselor [ 64 ]. On the other hand, some clinical settings may opt for implementing universal trauma-informed care under the assumption that any patient may have experienced childhood or other neglect and/or abuse.…”

Section: Discussionmentioning

confidence: 99%

“…Physicians reviewed the questionnaire responses with patients and provided an educational handout with relevant community and educational resources and, as needed, referrals for behavioral health services. Additional information about study methods has been published previously [ 29 , 46 , 47 , 48 , 49 ]. This study received approval from the KPNC Institutional Review Board with a waiver of informed consent.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Associations between Adverse Childhood Experiences (ACEs) and Prenatal Mental Health and Substance Use

Foti

Watson

Adams

et al. 2023

IJERPH

Self Cite

View full text Add to dashboard Cite

Adverse childhood experiences (ACEs) are common and increase the risk of poor health outcomes. Resilience may offer protection against the impacts of ACEs. This study examined the association between maternal ACEs and mental/behavioral health outcomes during pregnancy overall and by resilience. The sample comprised pregnant patients in two pilot studies screened for eight ACEs and resilience during standard prenatal care in Kaiser Permanente Northern California from 1 March 2016 to 30 July 2016 (Study 1, medical centers A, B) and from 1 April 2018 to 31 March 2019 (Study 2, medical centers A, C). Early pregnancy outcomes included anxiety and depressive disorders, depression symptoms, intimate partner violence (IPV), and substance use. Multivariable logistic regression was used in this cross-sectional study to examine associations between maternal ACEs (0, 1–2, ≥3) and mental/behavioral health outcomes overall and among those with low and high resilience. Patients (n = 1084) averaged 30.8 years (SD 5.1); 41.7% were non-Hispanic White; 41.7% experienced ≥1 ACE, and 40.3% had low resilience. Patients with 1–2 ACEs or ≥3 ACEs (versus 0 ACEs) had higher odds of anxiety and depressive disorders, depressive symptoms, IPV, and any prenatal substance use (OR 1.44–4.40, p < 0.05). Each individual ACE was associated with ≥2 mental/behavioral health outcomes. In stratified analyses, having ≥1 ACE (vs. 0) was associated with a greater number of mental/behavioral health outcomes among patients with low versus high resilience. ACEs were associated with prenatal mental/behavioral health conditions, particularly in the context of low resilience, highlighting the importance of trauma-informed prenatal care and the need to study resilience-building interventions during pregnancy.

show abstract

Adverse childhood experiences and prescription opioid use during pregnancy: an analysis of the North and South Dakota PRAMS, 2019–2020

Testa,

Jacobs,

Zhang

et al. 2023

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

Objectives This study assesses the association between adverse childhood experiences (ACEs) and prescription opioid use during pregnancy. Methods This study uses data on 2,999 individuals from the 2019 and 2020 Pregnancy Risk Assessment Monitoring System (PRAMS) from North Dakota and South Dakota. The relationship between ACEs and prescription opioid use during pregnancy is examined using multiple logistic regression. Results The prevalence of prescription opioid use increases alongside more ACE exposure. Compared to those with no ACEs, recent mothers with three or more ACEs have a 2.4 greater odds of prescription opioid use during pregnancy (aOR [adjusted odds ratio] = 2.437; 95% CI [confidence interval] = 1.319, 4.503). Conclusion Exposure to three or more ACEs are associated with a higherrisk of prescription opioid use during pregnancy. Additional research is needed better understand the mechanisms that link ACEs and prescription opioid use during pregnancy, as well as how to best support those with ACEs exposure in a trauma-informed manner to reduce the risk of substance use.

show abstract

Promising Practices for Implementing Adverse Childhood Experiences and Resilience Screening in Obstetric Care

Cited by 3 publications

References 18 publications

Adverse Childhood Experiences and Prescription Opioid Use During Pregnancy: An Analysis of the North and South Dakota PRAMS, 2019-2020

Adverse Childhood Experiences and Prescription Opioid Use During Pregnancy: An Analysis of the North and South Dakota PRAMS, 2019-2020

Associations between Adverse Childhood Experiences (ACEs) and Prenatal Mental Health and Substance Use

Adverse childhood experiences and prescription opioid use during pregnancy: an analysis of the North and South Dakota PRAMS, 2019–2020

Contact Info

Product

Resources

About