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Pingeton BC, Nieser KJ, Cochran A, Goodman SH, Laurent H, Sbrilli MD, Knight B, Newport DJ, Stowe ZN. Childhood maltreatment exposure is differentially associated with transdiagnostic perinatal depression symptoms. J Affect Disord 2024; 358:183-191. [PMID: 38705531 DOI: 10.1016/j.jad.2024.05.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 04/25/2024] [Accepted: 05/02/2024] [Indexed: 05/07/2024]
Abstract
History of childhood maltreatment (CM) is common and robustly associated with prenatal and postpartum (perinatal) depression. Given perinatal depression symptom heterogeneity, a transdiagnostic approach to measurement could enhance understanding of patterns between CM and perinatal depression. METHODS In two independently collected samples of women receiving care at perinatal psychiatry clinics (n = 523 and n = 134), we categorized longitudinal symptoms of perinatal depression, anxiety, stress, and sleep into transdiagnostic factors derived from the Research Domain Criteria and depression literatures. We split the perinatal period into four time points. We conducted a latent profile analysis of transdiagnostic factors in each period. We then used self-reported history of CM (total exposure and subtypes of abuse and neglect) to predict class membership. RESULTS A three-class solution best fit our data. In relation to positive adaptive functioning, one class had relatively more positive symptoms (high adaptive), one class had average values (middle adaptive), and one class had fewer adaptive symptoms (low adaptive). More total CM and specific subtypes associated with threat/abuse increased an individual's likelihood of being in the Low Adaptive class in both samples (ORs: 0.90-0.97, p < .05). LIMITATIONS Generalizability of our results was curtailed by 1) limited racial/ethnic diversity and 2) missing data. CONCLUSIONS Our results support taking a person-centered approach to characterize the relationship between perinatal depression and childhood maltreatment. Given evidence that increased exposure to childhood maltreatment is associated with worse overall symptoms, providers should consider incorporating preventative, transdiagnostic interventions for perinatal distress in individuals with a history of childhood maltreatment.
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Affiliation(s)
- Blaire C Pingeton
- Institute for Innovations in Developmental Sciences, Northwestern University Feinberg School of Medicine, United States of America.
| | - Kenneth J Nieser
- Department of Population Health Sciences, University of Wisconsin, United States of America
| | - Amy Cochran
- Department of Population Health Sciences, University of Wisconsin, United States of America; Department of Mathematics, University of Wisconsin, United States of America
| | - Sherryl H Goodman
- Department of Psychology, Emory University, United States of America
| | - Heidemarie Laurent
- Department of Psychology, University of Illinois at Urbana-Champaign, United States of America
| | - Marissa D Sbrilli
- Department of Psychology, University of Illinois at Urbana-Champaign, United States of America
| | - Bettina Knight
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, United States of America
| | - D Jeffrey Newport
- Departments of Psychiatry and Behavioral Sciences and Women's Health, University of Texas at Austin Dell Medical School, United States of America
| | - Zachary N Stowe
- Department of Psychiatry, University of Wisconsin at Madison, United States of America
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Terada S, Isumi A, Yamaoka Y, Fujiwara T. Years of education mediate the association between adverse childhood experiences and unintended pregnancy: A population-based study in Japan. CHILD ABUSE & NEGLECT 2024; 153:106817. [PMID: 38718477 DOI: 10.1016/j.chiabu.2024.106817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 04/15/2024] [Accepted: 04/23/2024] [Indexed: 06/12/2024]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) have been associated with unintended pregnancies, including mistimed pregnancies (MP) and unwanted pregnancies (UWP). However, it remains unknown which cluster of ACEs (i.e., child maltreatment/household dysfunction and deprivation/threat) are associated with MP/UWP and whether years of education mediate these associations. OBJECTIVE To investigate the association of the clusters of ACEs with MP and UWP, while also examining the mediating effect of education years. PARTICIPANTS AND SETTING A retrospective cohort study among 7652 postpartum women in Chiba, Japan. METHODS MP/UWP was defined by emotional responses to confirming pregnancy. Multinomial logistic regression analyses with multiple imputed datasets estimated the relative risk ratio (RRR) of MP/UWP by cumulative scores and each cluster of ACEs. Causal mediation analysis assessed the indirect effects of years of education. RESULTS Women with 4 or more ACEs were at a 2.4 times higher risk of MP (95 % confidence interval (CI): 1.6-3.8) and a 5.0 times higher risk of UWP (95 % CI: 3.1-8.2). Among ACE clusters, having 3 or more household dysfunction showed the strongest association with MP (RRR: 1.91, 95 % CI: 1.23-2.95), and having 3 or more deprivation showed the strongest association with UWP (RRR: 3.69, 95 % CI: 2.00-6.83). Education years mediated 16 % and 11 % of the association between total ACEs and MP/UWP, respectively, with a similar trend observed in each cluster. CONCLUSIONS Not only ACEs score but also each cluster of ACEs was associated with MP and UWP. The mediating effects of years of education were modest.
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Affiliation(s)
- Shuhei Terada
- Department of Public Health, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-Ku, Tokyo 113-8519, Japan
| | - Aya Isumi
- Department of Health Policy, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-Ku, Tokyo 113-8519, Japan
| | - Yui Yamaoka
- Department of Public Health, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-Ku, Tokyo 113-8519, Japan
| | - Takeo Fujiwara
- Department of Public Health, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-Ku, Tokyo 113-8519, Japan; Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, 615 N Wolfe St, Baltimore, MD 21205, USA.
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3
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Zamani-Hank Y, Brincks A, Talge NM, Slaughter-Acey J, Margerison C. The Association Between Adverse Childhood Experiences and Preterm Delivery: A Latent Class Approach. J Womens Health (Larchmt) 2024; 33:522-531. [PMID: 38457646 DOI: 10.1089/jwh.2023.0196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2024] Open
Abstract
Background: Racial and socioeconomic status (SES) disparities in preterm delivery (PTD) have existed in the United States for decades. Disproportionate maternal exposures to adverse childhood experiences (ACEs) may increase the risk for adverse birth outcomes. Moreover, racial and SES disparities exist in the prevalence of ACEs, underscoring the need for research that examines whether ACEs contribute to racial and SES disparities in PTD. Methods: We examined the relationship between ACEs and PTD in a longitudinal sample of N = 3,884 women from the National Longitudinal Study of Adolescent to Adult Health (1994-2018). We applied latent class analysis to (1) identify subgroups of women characterized by patterns of ACE occurrence; (2) estimate the association between latent class membership (LCM) and PTD, and (3) examine whether race and SES influence LCM or the association between LCM and PTD. Results: Two latent classes were identified, with women in the high ACEs class characterized by a higher probability of emotional abuse, physical abuse, sexual abuse, and foster care placement compared with the low ACEs class, but neither class was associated with PTD. Race and SES did not predict LCM. Conclusions: Our findings suggest that ACEs may not impact PTD risk in previously hypothesized ways. Future research should assess the impact of ACEs on the probability of having live birth pregnancies as well as the role of potential protective factors in mitigating the impact of ACEs on PTD.
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Affiliation(s)
- Yasamean Zamani-Hank
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, Michigan, USA
| | - Ahnalee Brincks
- Department of Human Development and Family Studies, Michigan State University, East Lansing, Michigan, USA
| | - Nicole M Talge
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, Michigan, USA
| | - Jaime Slaughter-Acey
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Claire Margerison
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, Michigan, USA
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4
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Erato G, Shreffler KM, Ciciolla L, Quigley A, Addante S. Maternal childhood adversity and pregnancy intentions as predictors of pregnancy happiness. J Reprod Infant Psychol 2024; 42:180-193. [PMID: 35819014 PMCID: PMC9834437 DOI: 10.1080/02646838.2022.2097208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 06/28/2022] [Indexed: 01/14/2023]
Abstract
OBJECTIVES Nearly half of all pregnancies in the U.S. are classified as unintended (e.g. unplanned, mistimed, or unwanted), which have been linked to numerous adverse consequences for maternal and child outcomes. Recent evidence suggests that happiness about a pregnancy is often a better predictor of maternal and infant health outcomes than pregnancy intentions, but few studies have examined maternal predictors of pregnancy happiness. METHODS Using a clinic-based sample of pregnant women (n = 177), we apply multiple regression analysis to examine the association between maternal adverse childhood experiences and pregnancy happiness, as well as the moderating role of pregnancy intentions. RESULTS Women with more childhood adversity and pregnancies that were unplanned and mistimed or unwanted reported lower levels of pregnancy happiness, compared with women with less childhood adversity and intended pregnancies. However, pregnancy intentions did not moderate the relationship between maternal adverse childhood experiences and pregnancy happiness. CONCLUSION Our results suggest that pregnancy happiness is lower among mothers with a history of childhood adversity and pregnancies classified as unplanned and mistimed or unwanted. Understanding the factors that impact pregnancy happiness is critical to inform prenatal clinical practice and health policy, particularly when caring for those with a history of adversity.
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Affiliation(s)
- Gina Erato
- Department of Psychology, Oklahoma State University
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5
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Islam MJ. The Relationship Between Childhood Abuse and Unintended Pregnancy Among Married Women of Reproductive Age in Bangladesh. JOURNAL OF CHILD SEXUAL ABUSE 2024; 33:243-261. [PMID: 38326755 DOI: 10.1080/10538712.2024.2314283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 01/27/2024] [Indexed: 02/09/2024]
Abstract
Childhood abuse has been associated with adverse medical, psychological, behavioral, and socioeconomic outcomes in adulthood. Despite this, limited research explores the connection between childhood abuse and unintended pregnancy during adulthood. Notably, existing studies have predominantly focused on high-income countries, leaving a significant gap regarding low- and middle-income nations. This study aims to investigate the impact of childhood physical, sexual, and psychological abuse on the prevalence of unintended pregnancies and explore the interaction effects of childhood abuse on unintended pregnancy occurrences. The cross-sectional survey study was conducted between October 2015 and January 2016 in the Chandpur District of Bangladesh. Data were collected from 426 married women aged 15-49 years who had at least one child of six months or younger. The assessment of child abuse pertains to the mother's own experiences of childhood abuse and not abuse inflicted on her child. The prevalence of childhood physical, psychological, and sexual abuse was 37%, 26%, and 15%, respectively. About 25.1% of their most recent pregnancies were unintended. Notably, women with a history of childhood sexual abuse were twice as likely to experience unintended pregnancy compared to those without such a history. Furthermore, a dose-response connection was observed between the combined exposure of all categories of childhood abuse and a higher risk of unintended pregnancy. These findings highlight the need for targeted interventions, such as comprehensive sex education, accessible mental health support, and improved child protection frameworks, to address the potential repercussions of maternal childhood abuse and reduce the incidence of unintended pregnancies.
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Juarez PD. Economic Determinants of Health Disparities and the Role of the Primary Care Provider. Prim Care 2023; 50:561-577. [PMID: 37866831 DOI: 10.1016/j.pop.2023.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2023]
Abstract
The economic determinants of adverse personal health outcomes and population level disparities pose a daunting challenge for primary care providers in promoting health for persons experiencing poverty and neighborhood deprivation. Until they are addressed, however, the health and economic well-being of persons experiencing neighborhood deprivation is not likely to be improved. There is growing evidence of effective interventions that primary care providers can adopt to address social and economic determinants of health. Primary care providers can participate in clinic and community-based approaches that target individual, neighborhood and social level drives of health and disparities.
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Affiliation(s)
- Paul D Juarez
- Department of Family & Community Medicine, Meharry Medical College, 1005 Dr. DB Todd Jr. Boulevard, Nashville, TN 37208, USA.
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Kanamori Y, Miyamoto Y, Sawada U, Iida M, Tabuchi T, Nishi D. Association between adverse childhood experience and unintended pregnancy among Japanese women: a large-scale cross-sectional study. J Psychosom Obstet Gynaecol 2023; 44:2274295. [PMID: 37882689 DOI: 10.1080/0167482x.2023.2274295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 10/18/2023] [Indexed: 10/27/2023] Open
Abstract
Unintended pregnancy (UP) can negatively impact the health of mothers, children, and families. While Adverse Childhood Experiences (ACEs) are increasingly known to affect sexual health, the influence on pregnancy intention is not fully understood. This study examines the relationship between ACEs and UP and explores other related factors, using 5049 pregnant and postpartum women data from the Japan COVID-19 and Society Internet Survey (JACSIS). We measured participants' pregnancy intentions, ACEs, family functioning, and social network size. Logistic regression analysis provided odds ratios and 95% confidence intervals (CI). The prevalence of UP was approximately 16.5% (n = 893). Cumulative ACEs were consistently associated with UP, even after adjusting for intermediate variables in adulthood. The odds ratio for UP with a single ACE was 1.00 (CI: 0.82-1.21) but rose significantly with multiple ACEs: 1.39 (CI: 1.10-1.76) with double, 1.38 (CI: 1.02-2.86) with triple, and 1.81 (CI: 1.37-2.39) with more. Additionally, bad family functioning and lack of social networks emerged as contributors to UP. In conclusion, this study showed that ACEs are potentially correlated with UP. A deeper understanding of the transition from childhood experiences to UP is important for health interventions, necessitating further investigation.
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Affiliation(s)
- Yoshiaki Kanamori
- Department of Psychiatric Nursing, Graduate School of Medicine, The University of Tokyo, Bunkyo-Ku, Tokyo, Japan
| | - Yuki Miyamoto
- Department of Psychiatric Nursing, Graduate School of Medicine, The University of Tokyo, Bunkyo-Ku, Tokyo, Japan
| | - Utako Sawada
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-Ku, Tokyo, Japan
| | - Mako Iida
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-Ku, Tokyo, Japan
| | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | - Daisuke Nishi
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-Ku, Tokyo, Japan
- Department of Public Mental Health Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
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Johnsen H, Juhl M, Rydahl E, Karentius SM, Rath SM, Friis-Alstrup M, Backhausen MG, Røhder K, Schiøtz ML, Broberg L, de Lichtenberg V. The Feasibility of the Adverse Childhood Experiences Questionnaire among Women in Danish Antenatal Care: A Mixed-Methods Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6601. [PMID: 37623184 PMCID: PMC10454047 DOI: 10.3390/ijerph20166601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 06/27/2023] [Accepted: 07/12/2023] [Indexed: 08/26/2023]
Abstract
A traumatic upbringing increases the risks of antenatal health problems, unfavourable pregnancy outcomes, and mental disorders. Such childhood experiences may affect women's pa-renting skills and the social-emotional functioning of their children. Research on screening for adverse childhood experiences in antenatal care is limited. The objective of this study was to explore pregnant women's attitudes towards and experiences of an adverse childhood experiences questionnaire, and to assess the relevance of the questionnaire among a population of pregnant women referred to antenatal care levels one and two, targeting women who are generally not perceived to be vulnerable. Data were collected at three maternity wards and consisted of quantitative data on 1352 women's adverse childhood experience scores, structured observations of 18 midwifery visits, and in-depth interviews with 15 pregnant women. Quantitative data were analysed by descriptive statistics, and qualitative data were analysed using systematic text condensation. The qualitative analysis revealed two main categories: "Being screened for childhood adversities" and "Having adverse childhood experiences". In the study population, the prevalence of adverse childhood experiences was high. The women assessed the adverse childhood experiences questionnaire to be a relevant and acceptable screening method. Furthermore, women's perceptions of their relationship with their midwife greatly impacted their attitudes towards and experiences of the questionnaire.
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Affiliation(s)
- Helle Johnsen
- Department of Midwifery and Therapeutic Sciences, University College Copenhagen, Sigurdsgade 26, 2200 Copenhagen, Denmark
| | - Mette Juhl
- Department of Midwifery and Therapeutic Sciences, University College Copenhagen, Sigurdsgade 26, 2200 Copenhagen, Denmark
| | - Eva Rydahl
- Department of Midwifery and Therapeutic Sciences, University College Copenhagen, Sigurdsgade 26, 2200 Copenhagen, Denmark
| | - Sara Mbaye Karentius
- Department of Midwifery and Therapeutic Sciences, University College Copenhagen, Sigurdsgade 26, 2200 Copenhagen, Denmark
| | - Sabine Marie Rath
- Department of Gynaecology and Obstetrics, Holbæk Hospital, Smedelundsgade 60, 4300 Holbæk, Denmark;
| | | | - Mette Grønbæk Backhausen
- Department of Gynaecology and Obstetrics, Zealand University Hospital Roskilde, Sygehusvej 10, 4000 Roskilde, Denmark;
| | - Katrine Røhder
- Department of Psychology, Copenhagen University, Øster Farimagsgade 2A, 1350 Copenhagen, Denmark;
- The Family Clinic, Department of Obstetrics and Gynaecology, Amager and Hvidovre Hospital, Pavillon 4, Østre Hospitalsvej 5A, 2650 Hvidovre, Denmark
| | - Michaela Louise Schiøtz
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg University Hospital, The Capital Region of Denmark, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark (L.B.)
| | - Lotte Broberg
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg University Hospital, The Capital Region of Denmark, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark (L.B.)
| | - Vibeke de Lichtenberg
- Department of Midwifery and Therapeutic Sciences, University College Copenhagen, Sigurdsgade 26, 2200 Copenhagen, Denmark
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Johnsen H, Lichtenberg VD, Rydahl E, Karentius SM, Dueholm SCH, Friis-Alstrup M, Backhausen MG, Røhder K, Schiøtz ML, Broberg L, Juhl M. The Feasibility and Acceptability of the Adverse Childhood Experiences Questionnaire in Danish Antenatal Care-A Qualitative Study of Midwives' Implementation Experiences. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20105897. [PMID: 37239623 DOI: 10.3390/ijerph20105897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/09/2023] [Accepted: 05/15/2023] [Indexed: 05/28/2023]
Abstract
Adverse childhood experiences have a potential lifelong impact on health. A traumatic upbringing may increase antenatal health risks in mothers-to-be and impact child development in their offspring. Yet, little is known about the identification of adverse childhood experiences in antenatal care. The objective of this study was to explore the feasibility and acceptability of the adverse childhood experiences questionnaire among midwives and factors affecting its implementation. Three Danish maternity wards participated in the study. The data consisted of observations of midwifery visits and informal conversations with midwives, as well as mini group interviews and dialogue meetings with midwives. The data were analysed using systematic text condensation. Analysis of the data revealed three main categories; "Relevance of the adverse childhood experiences questionnaire", "Challenges related to use of the adverse childhood experiences questionnaire" and "Apprehensions, emotional strain, and professional support". The findings showed that the adverse childhood experiences questionnaire was feasible to implement in Danish antenatal care. Midwives' acceptability of the questionnaire was high. Training courses and dialogue meetings motivated the midwives to work with the questionnaire in practice. The main factors affecting the implementation process were time restrictions, worries of overstepping women's boundaries, and a lack of a specific intervention for women affected by their traumatic upbringing circumstances.
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Affiliation(s)
- Helle Johnsen
- Department of Midwifery and Therapeutic Sciences, University College Copenhagen, Sigurdsgade 26, 2200 Copenhagen N, Denmark
| | - Vibeke de Lichtenberg
- Department of Midwifery and Therapeutic Sciences, University College Copenhagen, Sigurdsgade 26, 2200 Copenhagen N, Denmark
| | - Eva Rydahl
- Department of Midwifery and Therapeutic Sciences, University College Copenhagen, Sigurdsgade 26, 2200 Copenhagen N, Denmark
| | - Sara Mbaye Karentius
- Department of Midwifery and Therapeutic Sciences, University College Copenhagen, Sigurdsgade 26, 2200 Copenhagen N, Denmark
| | | | | | - Mette Grønbæk Backhausen
- Department of Gynecology and Obstetrics, Zealand University Hospital Roskilde, Sygehusvej 10, 4000 Roskilde, Denmark
| | - Katrine Røhder
- Institute for Psychology, Copenhagen University, Øster Farimagsgade 2A, 1350 Copenhagen K, Denmark
- The Family Clinic, Department of Obstetrics and Gynaecology, Amager and Hvidovre Hospital, Pavillon 4, Østre Hospitalsvej 5A, 2650 Hvidovre, Denmark
| | - Michaela Louise Schiøtz
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg University Hospital, The Capital Region of Denmark, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark
| | - Lotte Broberg
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg University Hospital, The Capital Region of Denmark, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark
| | - Mette Juhl
- Department of Midwifery and Therapeutic Sciences, University College Copenhagen, Sigurdsgade 26, 2200 Copenhagen N, Denmark
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10
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Swedo EA, D'Angelo DV, Fasula AM, Clayton HB, Ports KA. Associations of Adverse Childhood Experiences With Pregnancy and Infant Health. Am J Prev Med 2023; 64:512-524. [PMID: 36697281 PMCID: PMC10033436 DOI: 10.1016/j.amepre.2022.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 10/25/2022] [Accepted: 10/27/2022] [Indexed: 01/25/2023]
Abstract
INTRODUCTION Adverse childhood experiences are associated with a host of negative outcomes; however, few have studied cumulative adverse childhood experiences in the context of pregnancy and infant health. This study examines state-level prevalence of adverse childhood experiences and associations with pregnancy- and infant health‒related indicators. METHODS The study used 2016-2018 Pregnancy Risk Assessment Monitoring System population-based data from 5 states. Analyses were conducted for individual states and grouped states using similar adverse childhood experience items. Thirteen adverse childhood experience measures were included across 3 domains: abuse, neglect, and household challenges. Adverse childhood experience scores were calculated for the number of adverse childhood experiences experienced (0, 1, 2, ≥3) on the basis of available state measures. Fourteen pregnancy- and infant health‒related indicators were examined, including unwanted pregnancy, adequate prenatal care, experiences during pregnancy (e.g., smoking, abuse, depression), gestational diabetes, hypertensive disorders of pregnancy, birth outcomes (e.g., preterm birth), and breastfeeding. Adjusting for demographics, parity, health insurance status, and educational attainment, prevalence ratios and 95% CIs were calculated to examine the associations between pregnancy- and infant health‒related indicators and adverse childhood experience scores. RESULTS Over 50% of respondents reported at least 1 adverse childhood experience and 13%-31% reported ≥3 adverse childhood experiences, depending on the state. Significant associations were identified in all adjusted models between adverse childhood experiences and unwanted pregnancy, smoking, physical abuse, and depression during pregnancy. CONCLUSIONS Adverse childhood experiences are associated with risk factors that impact pregnancy and infant health. Preventing and mitigating adverse childhood experiences is an important strategy to improve pregnancy- and infant health‒related indicators.
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Affiliation(s)
- Elizabeth A Swedo
- From the Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Denise V D'Angelo
- From the Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Amy M Fasula
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Heather B Clayton
- From the Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Katie A Ports
- and the Health Equity Research Applied, Albuquerque, New Mexico
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Hou Y, Shang M, Yu X, Gu Y, Li H, Lu M, Jiang M, Zhen H, Zhu B, Tao F. Joint effects of recent stressful life events and adverse childhood experiences on perinatal comorbid anxiety and depression. BMC Pregnancy Childbirth 2023; 23:41. [PMID: 36653742 PMCID: PMC9847044 DOI: 10.1186/s12884-023-05375-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 01/11/2023] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Stressful life events (SLEs) and adverse childhood experiences (ACEs) have been reported to be associated with perinatal depression (PND) or perinatal anxiety (PNA) alone; however, in most cases, majority of PND and PNA coexist and could lead to more serious health consequences. The independent effect of recent SLEs and their joint effects with ACEs on perinatal comorbid anxiety and depression (CAD) remain inadequately explored. METHODS Based on a longitudinal study, 1082 participants receiving prenatal care in Ma'anshan, China were included. Women were recruited in the first trimester (T1: ≤14+ 6 weeks) and followed up at 15 ~ 27 weeks (T2), 28 ~ 40 weeks (T3), and postpartum (T4). Depression and anxiety status were assessed at all time points, while recent SLEs and ACEs were measured at T1. Logistic regression was conducted to examine the associations of SLEs with the risks of CAD at different time points, as well as their joint effects with ACEs on CAD. RESULTS Approximately 38.5% of women experienced at least one SLE, which was significantly associated with higher risks of CAD at all time points (p < 0.05). As the number of SLEs increased, the risk of CAD increased (p for trend < 0.05). Specific types of SLEs were associated with CAD in different periods, while only interpersonal events were consistently associated with risks of CAD throughout the whole perinatal period. The joint effects of SLEs with ACEs on CAD were identified throughout the perinatal period, with the highest observed in the first trimester (aOR = 7.47, 95% CI: 3.73-14.95; p for trend < 0.001). CONCLUSION Our study demonstrated independent associations of recent SLEs and their joint effects with ACEs with risks of perinatal CAD. SLEs combined with ACEs should be recognized as a major risk factor for perinatal CAD and managed at the earliest time to prevent and control CAD.
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Affiliation(s)
- Yanyan Hou
- grid.186775.a0000 0000 9490 772XDepartment of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, 230032 Hefei, Anhui China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People’s Republic of China, No 81 Meishan Road, 230032 Hefei, Anhui China ,grid.186775.a0000 0000 9490 772XAnhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, 230032 Hefei, Anhui China ,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, 230032 Hefei, Anhui China
| | - Mengqing Shang
- grid.186775.a0000 0000 9490 772XDepartment of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, 230032 Hefei, Anhui China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People’s Republic of China, No 81 Meishan Road, 230032 Hefei, Anhui China ,grid.186775.a0000 0000 9490 772XAnhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, 230032 Hefei, Anhui China ,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, 230032 Hefei, Anhui China
| | - Xiayan Yu
- grid.186775.a0000 0000 9490 772XDepartment of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, 230032 Hefei, Anhui China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People’s Republic of China, No 81 Meishan Road, 230032 Hefei, Anhui China ,grid.186775.a0000 0000 9490 772XAnhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, 230032 Hefei, Anhui China ,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, 230032 Hefei, Anhui China
| | - Yue Gu
- grid.186775.a0000 0000 9490 772XDepartment of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, 230032 Hefei, Anhui China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People’s Republic of China, No 81 Meishan Road, 230032 Hefei, Anhui China ,grid.186775.a0000 0000 9490 772XAnhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, 230032 Hefei, Anhui China ,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, 230032 Hefei, Anhui China
| | - Haiyan Li
- grid.186775.a0000 0000 9490 772XDepartment of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, 230032 Hefei, Anhui China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People’s Republic of China, No 81 Meishan Road, 230032 Hefei, Anhui China ,grid.186775.a0000 0000 9490 772XAnhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, 230032 Hefei, Anhui China ,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, 230032 Hefei, Anhui China
| | - Mengjuan Lu
- grid.186775.a0000 0000 9490 772XDepartment of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, 230032 Hefei, Anhui China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People’s Republic of China, No 81 Meishan Road, 230032 Hefei, Anhui China ,grid.186775.a0000 0000 9490 772XAnhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, 230032 Hefei, Anhui China ,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, 230032 Hefei, Anhui China
| | - Minmin Jiang
- grid.419897.a0000 0004 0369 313XKey Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People’s Republic of China, No 81 Meishan Road, 230032 Hefei, Anhui China ,grid.186775.a0000 0000 9490 772XAnhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, 230032 Hefei, Anhui China ,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, 230032 Hefei, Anhui China ,grid.186775.a0000 0000 9490 772XDepartment of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, 230032 Hefei, Anhui China
| | - Hualong Zhen
- grid.419897.a0000 0004 0369 313XKey Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People’s Republic of China, No 81 Meishan Road, 230032 Hefei, Anhui China ,grid.186775.a0000 0000 9490 772XAnhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, 230032 Hefei, Anhui China ,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, 230032 Hefei, Anhui China ,grid.186775.a0000 0000 9490 772XDepartment of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, 230032 Hefei, Anhui China
| | - Beibei Zhu
- grid.186775.a0000 0000 9490 772XDepartment of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, 230032 Hefei, Anhui China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People’s Republic of China, No 81 Meishan Road, 230032 Hefei, Anhui China ,grid.186775.a0000 0000 9490 772XAnhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, 230032 Hefei, Anhui China ,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, 230032 Hefei, Anhui China
| | - Fangbiao Tao
- grid.186775.a0000 0000 9490 772XDepartment of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, 230032 Hefei, Anhui China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People’s Republic of China, No 81 Meishan Road, 230032 Hefei, Anhui China ,grid.186775.a0000 0000 9490 772XAnhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, 230032 Hefei, Anhui China ,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, 230032 Hefei, Anhui China
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12
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Feld HC, Leistner CE, Jones A, Wiggins AT. Unintended pregnancy and childhood maltreatment: The protective effect of positive relationships. Public Health Nurs 2023; 40:28-35. [PMID: 36300834 DOI: 10.1111/phn.13142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 09/27/2022] [Accepted: 09/29/2022] [Indexed: 01/14/2023]
Abstract
BACKGROUND Childhood maltreatment is associated with sexual risk-taking behaviors in adulthood but can also have generational effects on maternal/child health. METHODS This cross-sectional study examined the relationship between childhood abuse and neglect and unintended pregnancy, and then assessed the effect of relationship attributes on this outcome. RESULTS Findings indicate parenting women (n = 153) in long-term relationships who experienced childhood emotional abuse had higher scores of unintended pregnancies (p = .023). Yet women with moderate/high partner appraisal (perceptions of their partner's attributes used to assess interpersonal conflicts) showed no difference in unintended pregnancies between those with and without emotional abuse in childhood. Women with emotional abuse and low partner appraisal had higher unintended pregnancy scores (p = .002). DISCUSSION/CONCLUSION This study has implications for public health nursing and life course research demonstrating that a positive adult interpersonal environment can reduce the sequelae of adverse health outcomes associated with childhood emotional abuse. The results reinforce the importance of screening adults for childhood maltreatment to establish early risk for unintended pregnancy.
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Affiliation(s)
- Hartley C Feld
- University of Kentucky, College of Nursing, Lexington, Kentucky
| | - Christine E Leistner
- Department of Public Health and Health Services Administration, California State University, Chico, California
| | - Aubrey Jones
- University of Kentucky, College of Social Work Lexington, Lexington, Kentucky
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13
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Tran N, Callaway L, Shen S, Biswas T, Scott JG, Boyle F, Mamun A. Screening for adverse childhood experiences in antenatal care settings: A scoping review. Aust N Z J Obstet Gynaecol 2022; 62:626-634. [PMID: 35909247 PMCID: PMC9796324 DOI: 10.1111/ajo.13585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 06/19/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are associated with many health problems in women during pregnancy, including depression/anxiety, gestational diabetes and adverse birth outcomes. However, unlike other health risk factors, screening for ACEs has not been widely implemented in antenatal care settings. AIMS The aim of the scoping review was to explore the challenges in screening for ACEs in antenatal care settings and to provide the lessons learnt and evidence that guide the practice of ACE screening for both healthcare providers and pregnant women. METHODS A five-stage process for conducting the scoping review was utilised. Searches of four key databases (PubMed, PsycINFO, CINAHL and SCOPUS) and reference lists from relevant studies were conducted. RESULTS Seven publications met the inclusion criteria. Challenges identified for healthcare providers in screening for ACEs include lack of knowledge and confidence in ACE tool and shortage of time and resources to undertake screening. Impediments for pregnant women include concerns about privacy. However, there were examples of effective practice for ACE screening in antenatal care settings that could apply widely. CONCLUSION Addressing impediments to ACE screening is critical in implementing trauma-informed practices that can identify women at risk of adverse health outcomes during pregnancy. A study on screening for ACEs in antenatal care in both public and private settings is needed to examine its feasibility and acceptability in the Australian context before being included in the National Perinatal Data Collection.
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Affiliation(s)
- Nam Tran
- Institute for Social Science ResearchThe University of QueenslandBrisbaneQueenslandAustralia,ARC Centre of Excellence for Children and Family over the Life CourseThe University of QueenslandBrisbaneQueenslandAustralia
| | - Leonie Callaway
- Department of Obstetric Medicine, Royal Brisbane and Women’s HospitalMetro North and Health ServiceBrisbaneQueenslandAustralia,School of Clinical MedicineUniversity of QueenslandBrisbaneQueenslandAustralia
| | - Sitong Shen
- School of PsychologyThe University of QueenslandBrisbaneQueenslandAustralia
| | - Tuhin Biswas
- Institute for Social Science ResearchThe University of QueenslandBrisbaneQueenslandAustralia,ARC Centre of Excellence for Children and Family over the Life CourseThe University of QueenslandBrisbaneQueenslandAustralia
| | - James G. Scott
- Metro North Mental Health ServiceRoyal Brisbane and Women’s HospitalBrisbaneQueenslandAustralia,Child & Youth Mental HealthQIMR Berghofer Medical Research InstituteBrisbaneQueenslandAustralia
| | - Fran Boyle
- Institute for Social Science ResearchThe University of QueenslandBrisbaneQueenslandAustralia,Centre of Research Excellence in Stillbirth (Stillbirth CRE)The University of QueenslandBrisbaneQueenslandAustralia
| | - Abdullah Mamun
- Institute for Social Science ResearchThe University of QueenslandBrisbaneQueenslandAustralia,ARC Centre of Excellence for Children and Family over the Life CourseThe University of QueenslandBrisbaneQueenslandAustralia,Poche Centre for Indigenous HealthThe University of QueenslandBrisbaneQueenslandAustralia
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14
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Johnsen H, Juhl M, Møller BK, de Lichtenberg V. Adult Daughters of Alcoholic Parents-A Qualitative Study of These Women's Pregnancy Experiences and the Potential Implications for Antenatal Care Provision. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063714. [PMID: 35329401 PMCID: PMC8950929 DOI: 10.3390/ijerph19063714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 02/10/2022] [Accepted: 03/18/2022] [Indexed: 02/04/2023]
Abstract
The adult children of alcoholic parents are at increased risk of having health problems compared to the adult children of nonalcoholic parents. Little is known about how growing up with alcoholic parents affects women’s experiences when pregnant. The objectives of this study were to explore how adverse childhood experiences related to parental alcohol abuse affect women during their pregnancy and to assess the potential implications of women’s experiences for antenatal care provision. Twelve in-depth interviews were performed with women who were brought up by an alcoholic mother and/or father. Systematic text condensation was used to analyse the data. Two main categories were identified: ‘establishing relationships and having social support’ and ‘antenatal care encounters and concerns during pregnancy’. Women’s trust in others in adult life was impacted by their upbringing. Strained relationships with their parents and few friends meant that the women primarily relied on their partners for support. Neither antenatal care providers nor women talked about women’s childhood experiences at the visits. The women described concerns related to the baby’s health, lack of predictability and control during the pregnancy, as well as apprehensiveness regarding birth and motherhood. The potential implications for practice include systematic screening for adverse childhood experiences, antenatal preparation classes, parenting courses, and post-graduate training.
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15
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Testa A, Jackson DB, Ganson KT, Nagata JM. Maternal adverse childhood experiences and pregnancy intentions. Ann Epidemiol 2021; 64:47-52. [PMID: 34547446 DOI: 10.1016/j.annepidem.2021.09.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 08/20/2021] [Accepted: 09/14/2021] [Indexed: 12/25/2022]
Abstract
PURPOSE The current study investigates the association between maternal adverse childhood experiences (ACEs) and having an unwanted (i.e., a pregnancy that was undesired) or mistimed pregnancy (i.e., a pregnancy that occurred sooner than wanted). METHODS Data are from the 2018 North Dakota and South Dakota Pregnancy Risk Assessment Monitoring System (PRAMS) (N = 1897). Multinomial logistic regression analyses are used to assess the association between levels of ACE exposure and having an unwanted or mistimed pregnancy relative to an intended pregnancy. RESULTS Findings demonstrated that women with three ACEs (Relative Risk Ratio [RRR] = 2.157, 95% confidence interval [CI], 1.121-4.151) and four or more ACEs (RRR = 1.836, 95% CI, 1.181-2.854) had approximately twice the relative risk of having an unwanted pregnancy (vs. an intended pregnancy) compared to women with 0 ACEs. There was no association between ACEs and reporting a mistimed pregnancy. CONCLUSIONS These findings add to a burgeoning literature detailing how accumulating ACEs can create challenges for family planning by increasing the likelihood of having an unintended pregnancy. Study results suggest the need to devote greater resources to the prevention of ACEs and unintended pregnancies.
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Affiliation(s)
- Alexander Testa
- Department of Criminology & Criminal Justice, University of Texas at San Antonio, San Antonio.
| | - Dylan B Jackson
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University
| | - Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto
| | - Jason M Nagata
- Department of Pediatrics, University of California San Francisco
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16
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Thomas JL, Lewis JB, Ickovics JR, Cunningham SD. Associations between Adverse Childhood Experiences and Sexual Risk among Postpartum Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073848. [PMID: 33917634 PMCID: PMC8038841 DOI: 10.3390/ijerph18073848] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 03/31/2021] [Accepted: 04/04/2021] [Indexed: 11/16/2022]
Abstract
Epidemiological evidence suggests that exposure to adverse childhood experiences (ACEs) is associated with sexual risk, especially during adolescence, and with maternal and child health outcomes for women of reproductive age. However, no work has examined how ACE exposure relates to sexual risk for women during the postpartum period. In a convenience sample of 460 postpartum women, we used linear and logistic regression to investigate associations between ACE exposure (measured using the Adverse Childhood Experiences Scale) and five sexual risk outcomes of importance to maternal health: contraceptive use, efficacy of contraceptive method elected, condom use, rapid repeat pregnancy, and incidence of sexually transmitted infections (STIs). On average, women in the sample were 25.55 years of age (standard deviation = 5.56); most identified as Black (60.4%), White (18%), or Latina (14.8%). Approximately 40% were exposed to adversity prior to age 18, with the modal number of experiences among those exposed as 1. Women exposed to ACEs were significantly less likely to use contraception; more likely to elect less-efficacious contraceptive methods; and used condoms less frequently (p = 0.041 to 0.008). ACE exposure was not associated with rapid repeat pregnancy or STI acquisition, p > 0.10. Screening for ACEs during pregnancy may be informative to target interventions to reduce risky sexual behavior during the postpartum period.
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Affiliation(s)
- Jordan L. Thomas
- Department of Psychology, University of California Los Angeles (UCLA), Los Angeles, CA 90095, USA;
| | - Jessica B. Lewis
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT 06510, USA;
| | - Jeannette R. Ickovics
- Yale-NUS College, Singapore 138527, Singapore;
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT 06510, USA
| | - Shayna D. Cunningham
- Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, CT 06032, USA
- Correspondence: ; Tel.: +1-860-679-7642
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17
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Adverse Childhood Experiences on Reproductive Plans and Adolescent Pregnancy in the Gulf Resilience on Women's Health Cohort. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:ijerph18010165. [PMID: 33379385 PMCID: PMC7794759 DOI: 10.3390/ijerph18010165] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 12/22/2020] [Accepted: 12/24/2020] [Indexed: 12/28/2022]
Abstract
We investigated if adverse childhood experiences (ACEs) and ACE sub-types were associated with increased odds of planning to have children and adolescent pregnancy. The Gulf Resilience on Women’s Health (GROWH) is a diverse cohort of reproductive-age women living in southeastern Louisiana during the 2010 Deepwater Horizon oil spill. In our sample of 1482 women, we used multinomial logistic regression to model odds ratios of wanting future children and assessed effect measure modification by educational attainment. We also estimated odds ratios of adolescent pregnancy with binomial logistic regression. Exposure to ACEs increased odds of wanting future children across all ACE sub-types. Among women with lower educational attainment, three or more ACEs (overall, childhood, and adolescence) had over two times the odds of wanting future children. History of ACE and the various sub-types, except for emotional abuse, were associated with increased risk of adolescent pregnancy. ACEs may be linked to adolescent pregnancy and reproductive plans, and variations by educational status highlighted social discrepancies and importance of social context in evaluation and intervention.
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