Citation
Brant, Marisa; Wade, Roy; Passarella, Molly; Martin, Ashley; & Lorch, Scott (2017). Maternal Adverse Childhood Experiences and Adverse Birth Outcomes. Eastern Society for Pediatric Research Meeting. Philadelphia, PA.Abstract
Background:Adverse childhood experiences (ACEs), including abuse, neglect, and household dysfunction prior to the age of 18 have been associated with many risky adult behaviors and poor health outcomes, including premature death. Few studies have investigated the association between maternal ACE exposure and its effect on later pregnancy and birth outcomes.
Objective:
To investigate whether maternal ACE exposure is associated with an increased odds of having an adverse birth outcome (ABO), such as infants born small for gestational age (SGA), infants with a birthweight less than 2.5kg, preterm birth prior to 37 weeks’ gestation, and death during the birth hospitalization.
Design/Methods:
We constructed a retrospective cohort of female adolescents surveyed in grades 7-12 as part of The National Longitudinal Study of Adolescent to Adult Health (Add Health) who were followed for 15 years and reported a live birth during the follow-up period (N=2957). A woman’s ACE exposure was determined using responses to questions about childhood abuse, neglect, or household dysfunction (exposure to a household member with mental illness, incarceration of a household member, or parental separation). Univariable and logistic multivariable analysis determined the association of each ACE category and ABO after controlling for race/ethnicity, health insurance, income and level of education.
Results:
79% of the woman in the cohort reported exposure to at least 1 category of ACE and 18% reported exposure to 4 or more categories of ACE. 32% of the cohort had an ABO for at least one pregnancy. In univariate analysis, parental separation and sexual abuse were associated with an increased odds of having an ABO with an OR of 1.3 (95% CI 1.1 -1.5) and 1.3 (95% CI 1.0 - 1.6), respectively. However, when controlling for race and other sociodemographic factors, these ACE categories were no longer associated with an increased odds of having an ABO. In multivariable analysis, total ACE score (0-9) was also not found to have a significant correlation with ABOs (Adjusted OR 0.97, 95% CI 0.9-1.03).
Conclusion(s):
ACE exposure by itself is not a risk factor for ABOs in this cohort of US women. Instead, ACE exposure seems to be another marker of poor socioeconomic status, with a strong correlation seen between ACEs and women with black race, less education and lower incomes.
Reference Type
Conference proceedingBook Title
Eastern Society for Pediatric Research MeetingAuthor(s)
Brant, MarisaWade, Roy
Passarella, Molly
Martin, Ashley
Lorch, Scott