Maternal adverse childhood experiences and antepartum risks: the moderating role of social support
- 802 Downloads
The aims of the current study were to examine the association between maternal adverse childhood experiences (ACEs) and antepartum health risks, and to investigate whether social support moderated this association. It was hypothesized that ACEs would be associated with antepartum health risks; however, social support in the prenatal period would buffer mothers from the deleterious consequences of ACEs. Data from 1994 women (mean age = 31 years) and their infants were collected from a longitudinal cohort recruited in health care offices in Alberta, Canada. Pregnant women completed questionnaires related to ACEs prior to the age of 18 and prenatal social support, and a health care professional assessed the mother’s antepartum health risk. ACEs included physical, emotional, and sexual abuse, exposure to domestic violence, as well as exposure to household dysfunction such as parental substance use, mental illness, or incarceration. Regression analyses demonstrated a positive association between ACEs and antepartum health risks. However, a significant interaction between maternal ACEs and social support was also observed. Specifically, women exposed to high ACEs and low social support in pregnancy had high antepartum health risks. However, among mothers who had high ACEs but also high levels of social support, there was no association between ACEs and antepartum health risk. A history of ACEs can place mothers at risk of antepartum health complications. However, a resiliency effect was observed: women with a history of ACEs were buffered from experiencing antepartum health risks if they reported high levels of social support in pregnancy.
KeywordsAdverse child experiences Pregnancy Social support Reproductive health
We would like to thank the families and children who participated in our study.
The All Our Babies (AOB) study was funded by Alberta Innovates Health Solutions Interdisciplinary Team grant #200700595, Calgary, Alberta, Canada. Research support was provided to Dr. Madigan by the Alberta Children’s Hospital Foundation and the Canada Research Chairs program. Dr. Racine was supported by a Postdoctoral Trainee Award from the Social Sciences and Humanities Research Council and the Alberta Children’s Hospital Research Institute. Dr. Tough is an Alberta Innovates Health Solutions Health Scholar. Ms. Hetherington is supported by the Vanier Graduate Scholarship from the Canadian Institutes for Health Research. Funding sources had no role in publication related decision.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflicts of interest.
All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- Anda RF, Felitti VJ, Bremner JD, Walker JD, Whitfield C, Perry BD, Dube SR, Giles WH (2006) The enduring effects of abuse and related adverse experiences in childhood. A convergence of evidence from neurobiology and epidemiology. Eur Arch Psychiatry Clin Neurosci 256(3):174–186CrossRefGoogle Scholar
- Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss MP, Marks JS (1998) Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) study. Am J Prev Med 14(4):245–258CrossRefGoogle Scholar
- Hassan E (2005) Recall bias can be a threat to retrospective and prospective research designs. Internet J Epidemiol 3(2):1–7Google Scholar
- Mathews TJ, MacDorman MF (2013) Infant mortality statistics from the 2009 period linked birth/infant death data set. Natl Vital Stat Rep 61(8):1–27Google Scholar
- Patten SB, Wilkes TC, Williams JV, Lavorato DH, El-Guebaly N, Schopflocher D, Wild C, Colman I, Bulloch AG (2015) Retrospective and prospectively assessed childhood adversity in association with major depression, alcohol consumption and painful conditions. Epidemiol Psychiatr Sci 24(2):158–165CrossRefGoogle Scholar
- Program APH (2009) Delivery record—part one: antenatal risk assessment. from http://aphp.dapasoft.com/PublicHTML/doc/ABDelRecHS0001-126-1.pdf
- Racine N, Plamondon A, Madigan S, McDonald S, Tough S (2018b) Maternal adverse childhood experiences and infant development. PediatricsGoogle Scholar