Preconception and Prenatal Predictors of Early Experiences of Risk and Protection Among Alaska Children

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Our objective was to identify preconception and prenatal predictors of early experiences of co-occurring risk and protective factors to help target prevention efforts to the highest-need families prior to the birth of the child.


Data were from the Alaska Longitudinal Child Abuse and Neglect Linkage project and the 2012–2014 Alaska Child Understanding Behaviors Survey. We used latent class analysis and Vermunt’s three-step approach to examine predictors of latent classes of risk and protective factors among Alaska children.


Among children of Alaska Native/American Indian mothers, financial (OR 2.02, 95% CI 1.04, 3.90) and partner stress (OR 2.06, 95% CI 1.02, 4.10) prior to childbirth, maternal education < 12 years (OR 2.29, 95% CI 1.05, 4.96), and maternal substance use (OR 2.52, 95% CI 1.30, 4.89) were associated with a higher likelihood of membership in a high risk/moderate protection class as compared to a low socioeconomic status/high protection class. Among children of non-Native mothers, partner stress prior to childbirth (OR 3.92, 95% CI 1.08, 14.19), maternal education < 12 years (OR 2.69, 95% CI 1.24, 5.81), maternal substance use (OR 2.69, 95% CI 1.24, 5.81), younger maternal age (OR 0.87, 95% CI 0.80, 0.95), and a greater number of children (OR 1.62, 95% CI 1.09, 2.41) were associated with a higher likelihood of membership in a moderate risk/high protection class as compared to a low risk/moderate protection class.


Results can inform eligibility criteria for prenatal home visiting programs and prenatal screening in Alaska to ensure prevention programming and referrals are directed to families most in need of additional support.

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We would like to recognize the contributions of the multiple agencies that facilitated access to the data used in this study and the individuals who provided feedback on results interpretation. We would like to thank Kathy Perham-Hester (Alaska PRAMS coordinator) and Margaret Young (Alaska CUBS coordinator). We would also like to thank staff from the Alaska Department of Health and Social Services, Alaska Native Tribal Health Consortium, Alaska Office of Children’s Services, Alaska Resilience Initiative, and Alaska Child Welfare Academy. The findings reported herein were performed using data collected and maintained by the Alaska Division of Public Health. The opinions and conclusions expressed are solely those of the authors and should not be considered as representing the policy of any agency of the Alaska government.


The authors have no financial relationships to disclose.

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Correspondence to Anna E. Austin.

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Austin, A.E., Gottfredson, N.C., Zolotor, A.J. et al. Preconception and Prenatal Predictors of Early Experiences of Risk and Protection Among Alaska Children. Matern Child Health J 24, 82–89 (2020) doi:10.1007/s10995-019-02823-3

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  • Risk factors
  • Protective factors
  • Early childhood
  • Alaska Native/American Indian