Maternal Adverse Childhood Experiences and Infant Outcomes

Abstract
Background Adverse childhood experiences (ACEs) are common among women of child bearing age and associated with numerous negative health outcomes for both mothers and infants. Minimal research to date has examined relationships between maternal ACEs and the adverse birth outcomes of low birth weight (LBW) and small for gestational age (SGA).
Objectives a) To examine the relation between maternal ACEs and delivering an infant with LBW b) to examine the relation between maternal ACEs and delivering an infant with SGA c) to evaluate if the relation between maternal ACEs and LBW or SGA is moderated by prenatal cigarette smoking or illicit drug use.
Design and Methods A cross-sectional, secondary data analysis of a population-based data set from the Pregnancy Risk Assessment Monitoring System (PRAMS). Multiple logistic regressions were used to examine the relationships between the first two objectives, and multiple logistic regressions with interaction terms were used for the third objective.
Sample 78,153 (weighted sample) respondents from North Dakota and South Dakota, who had recently given birth and answered ACE questions through the PRAMS survey between the years of 2016 and 2020.
Findings No significant associations between maternal ACEs and LBW or SGA were detected. Moderation by prenatal smoking: respondents who smoked during pregnancy with a history of 1-3 ACEs (OR 2.08 95% CI 1.15, 3.77) or 4 or more ACEs (OR 1.88 95% CI 1.06, 3.34) were found to have greater odds of having a LBW infant than respondents with no history of ACEs who did not smoke while pregnant. Respondents who smoked during pregnancy with 4 or more ACEs had twice the odds of having a SGA infant (OR 2.08 95% CI 1.23, 3.28).
Moderation by prenatal illicit drug use: respondents who used illicit drugs during pregnancy with a history of 4 or more ACEs had greater odds of having a SGA infant (OR 1.76 95% CI 1.07, 2.89).
Conclusion This study provides insight into understanding the moderating role that prenatal smoking and illicit drug use play in the relationship between maternal ACEs and the infant outcomes of LBW and SGA. The study highlights the need for population-based surveys to include questions about ACEs in order to further understand the important relationships between maternal ACEs and the infant outcomes of LBW and SGA.