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. 2019 Oct 28;19(1):387.
doi: 10.1186/s12884-019-2560-8.

Adverse childhood experiences and poor birth outcomes in a diverse, low-income sample

Joshua P Mersky  1 , ChienTi Plummer Lee  2
Affiliations

Adverse childhood experiences and poor birth outcomes in a diverse, low-income sample

Joshua P Mersky et al. BMC Pregnancy Childbirth. .

Abstract

Background: Adverse childhood experiences (ACE) are associated with an array of health consequences in later life, but few studies have examined the effects of ACEs on women's birth outcomes.

Methods: We analyzed data gathered from a sample of 1848 low-income women who received services from home visiting programs in Wisconsin. Archival program records from a public health database were used to create three birth outcomes reflecting each participant's reproductive health history: any pregnancy loss; any preterm birth; any low birthweight. Multivariate logistic regressions were performed to test the linear and non-linear effects of ACEs on birth outcomes, controlling for age, race/ethnicity, and education.

Results: Descriptive analyses showed that 84.4% of women had at least one ACE, and that 68.2% reported multiple ACEs. Multivariate logistic regression analyses showed that cumulative ACE scores were associated with an increased likelihood of pregnancy loss (OR = 1.12; 95% CI = 1.08-1.17), preterm birth (OR = 1.07; 95% CI = 1.01-1.12), and low birthweight (OR = 1.08; 95% CI = 1.03-1.15). Additional analyses revealed that the ACE-birthweight association deviated from a linear, dose-response pattern.

Conclusions: Findings confirmed that high levels of childhood adversity are associated with poor birth outcomes. Alongside additive risk models, future ACE research should test interactive risk models and causal mechanisms through which childhood adversity compromises reproductive health.

Keywords: Adverse childhood experiences; Birth outcomes; Low Birthweight; Low-income; Pregnancy loss; Preterm birth; Reproductive health.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Mean of observed negative birth outcomes by the number of adverse childhood experiences
See this image and copyright information in PMC

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