Relative contribution of maternal adverse childhood experiences to understanding children’s externalizing and internalizing behaviours at age 5: findings from the All Our Families cohort

Hetherington, Erin; Racine, Nicole; Madigan, Sheri; McDonald, Sheila; Tough, Suzanne

doi:10.9778/cmajo.20190149

Cited by 19 publications

(17 citation statements)

References 61 publications

(62 reference statements)

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“… 14 For anxiety, cutoff scores for the STAI-SF have not been consistently established but a cutoff of 1 SD above the mean for anxiety has been used in previous literature. 19 , 20 We therefore used a STAI-SF score 1 SD above the mean at the 8-year timepoint to define clinically significant anxiety at all timepoints (total anxiety score ≥14) because the mean calculated for the 8-year timepoint was most proximal to the COVID-19 impact survey timepoint and had the highest cutoff across data collection waves, providing the most conservative estimate.…”

Section: Methodsmentioning

confidence: 99%

Maternal depressive and anxiety symptoms before and during the COVID-19 pandemic in Canada: a longitudinal analysis

Racine

Hetherington

McArthur

et al. 2021

The Lancet Psychiatry

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197

207

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Background Parents have faced substantial social and economic challenges during the COVID-19 pandemic. Preliminary cross-sectional research has demonstrated increases in mental health problems in mothers during the COVID-19 pandemic compared with pre-pandemic estimates. We aimed to study an existing longitudinal cohort of mothers to assess changes in the prevalence of maternal depression and anxiety symptoms as a result of the COVID-19 pandemic over time and at the individual level. Methods In this longitudinal observational study, women who took part in the All Our Families pregnancy cohort in Canada were invited to complete a COVID-19 impact survey between May 20 and July 15, 2020. Women who had not agreed to additional research, had discontinued, were lost to follow-up, or who were not contactable via email were excluded. Maternal depression and anxiety symptoms during the COVID-19 pandemic were compared with three previous estimates collected at 3, 5, and 8-year timepoints (between April, 2012, and October, 2019). Depression symptoms were assessed using the 10-item Center for Epidemiological Studies Depression scale and anxiety symptoms were assessed using the short form of the Spielberger State-Trait Anxiety Inventory. Repeated cross-sectional analyses were done to assess temporal trends and fixed-effects regression models were fitted to assess within-person change over time. Findings Of the 3387 women included in the All Our Families study, 2445 women were eligible and were invited to participate in the COVID-19 impact study, of whom 1333 consented to participate, and 1301 were included in the longitudinal analysis. At the COVID-19 impact survey timepoint, a higher proportion of mothers had clinically significant depression (35·21%, 95% CI 32·48–38·04) and anxiety symptoms (31·39%, 28·76–34·15) than at all previous data collection timepoints. The mean depression score (8·31, 95% CI 7·97–8·65) and anxiety score (11·90, 11·66–12·13) at the COVID-19 pandemic timepoint were higher than previous data collection waves at the 3-year timepoint (mean depression score 5·05, 4·85–5·25; mean anxiety score 9·51, 9·35–9·66), 5-year timepoint (mean depression score 5·43, 5·20–5·66; mean anxiety score 9·49, 9·33–9·65), and 8-year timepoint (mean depression score 5·79, 5·55–6·02; mean anxiety score 10·26, 10·10–10·42). For the within-person comparisons, depression scores were a mean of 2·30 points (95% CI 1·95–2·65) higher and anxiety scores were a mean of 1·04 points (0·65–1·43) higher at the COVID-19 pandemic timepoint, after controlling for time trends. Larger increases in depression and anxiety symptoms were observed for women who had income disruptions, difficulty balancing home schooling with work responsibilities, and those with difficulty obtaining childcare. White mothers had greater increases in anxiety scores than non-white mothers and health-care workers had smaller increases in depressive symptoms than non-health-care workers. ...

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Section: Methodsmentioning

confidence: 99%

Maternal depressive and anxiety symptoms before and during the COVID-19 pandemic in Canada: a longitudinal analysis

Racine

Hetherington

McArthur

et al. 2021

The Lancet Psychiatry

Self Cite

197

207

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show abstract

“…At infant age 36 months, mothers were asked to recall ACEs that occurred in their lives before the age of 18 using a detailed questionnaire adapted from the original ACE checklist [45]. For consistency with the original scoring of Felitti et al and in response to pilot testing, questions were simplified for some of the original ACE questions to elicit yes/no responses instead of frequencies (often/very often) during data collection [46]. Detailed information about specific ACE questions used in this study can be found in Table 1.…”

Section: Acesmentioning

confidence: 99%

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

Currie

Tough

2021

BMC Pregnancy Childbirth

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Background Adverse childhood experiences (ACEs) are associated with illicit drug use among pregnant women who are socioeconomically vulnerable. While it is assumed that the impact of ACEs on illicit drug use in pregnancy is reduced among women with higher socioeconomic status (SES), this assumption is not well tested in the literature. The objective of this study was to examine the impact of maternal ACEs on illicit drug use in a community-based sample of pregnant women with middle to high SES. Methods This study is a secondary analysis of a prospective cohort study that collected data from 1660 women during and after pregnancy in Calgary, Canada between 2008 and 2011 using mailed surveys. Illicit drug use in pregnancy was self-reported by women at 34–36 weeks gestation. An established scale examined maternal ACEs before 18 years. Logistic regression models and 95% confidence intervals tested associations between maternal ACE scores and illicit drug use in pregnancy. Results Overall, 3.1% of women in this predominantly married, well-educated, middle and upper middle income sample reported illicit drug use in pregnancy. Women with 2–3 ACEs had more than a two-fold increase, and women with 4 or more ACEs had almost a four-fold increase in illicit drug use in pregnancy, relative to women with 0–1 ACEs after adjustment for confounders. Exposure to child abuse was more consistently associated with illicit drug use in pregnancy than exposure to household dysfunction in childhood. Conclusions Maternal ACEs were common and associated with a moderate increase in the odds of illicit drug use in pregnancy among Canadian women with middle to high SES.

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“…For consistency with the original scoring of Felitti et al and in response to pilot testing, questions were simpli ed for some of the original ACE questions to elicit yes/no responses instead of frequencies (often/very often) during data collection. 36 Detailed information about speci c ACE questions used in this study can be found in Hetherington et al (2020) Appendix 1. 36…”

Section: Acesmentioning

confidence: 99%

“…36 Detailed information about speci c ACE questions used in this study can be found in Hetherington et al (2020) Appendix 1. 36…”

Section: Acesmentioning

confidence: 99%

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

Currie

Tough

2020

Preprint

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Abstract Background: Adverse childhood experiences (ACEs) are associated with illicit drug use among pregnant women who are socioeconomically vulnerable. While it is assumed that the impact of ACEs on illicit drug use is reduced among pregnant women who are well educated and have higher socioeconomic status, this assumption has not been well tested in the literature. The objective of this study was to examine the impact of maternal ACEs on illicit drug use among pregnant women who are well-educated women, have middle to high household incomes, and seeking regular prenatal care. Findings can inform clinicians about potential associations between ACEs and drug use in pregnancy within a population that they are frequently in contact with. Methods: This study is a secondary analysis of a prospective cohort study that collected data from 1,680 women during and after pregnancy in Calgary, Canada between 2008-2011 using mailed surveys. Illicit drug use in pregnancy was self-reported by women at 34-36 weeks gestation. An established scale examined maternal ACEs before 18 years. Logistic regression models and 95% confidence intervals tested associations between maternal ACE scores and illicit drug use in pregnancy. Results: Overall, 3.3% of women in this predominantly married, well-educated, middle and upper middle income sample (mean age 31 years) reported illicit drug use in pregnancy. Women with 2-3 ACEs had more than a two-fold increase, and women with 4 or more ACEs had almost a four-fold increase in illicit drug use in pregnancy, relative to women with 0-1 ACEs after adjustment for confounders. Exposure to child abuse was more consistently associated with illicit drug use in pregnancy than exposure to household dysfunction in childhood. Conclusions: Findings combine with others to speak to the public health significance of maternal ACEs on substance use among expectant mothers across the socioeconomic spectrum; particularly child abuse. This information, can be used by women and the clinicians serving them, to better understand the role that ACEs could play in their decision to use illicit drugs in pregnancy.

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Relative contribution of maternal adverse childhood experiences to understanding children’s externalizing and internalizing behaviours at age 5: findings from the All Our Families cohort

Cited by 19 publications

References 61 publications

Maternal depressive and anxiety symptoms before and during the COVID-19 pandemic in Canada: a longitudinal analysis

Maternal depressive and anxiety symptoms before and during the COVID-19 pandemic in Canada: a longitudinal analysis

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

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

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