Patterns of adverse childhood experiences and associations with prenatal substance use and poor infant outcomes in a multi-country cohort of mothers: a latent class analysis.

Journal: BMC pregnancy and childbirth

Volume: 22

Issue: 1

Year of Publication: 2022

Affiliated Institutions:  Social Work Department, University of Edinburgh, Edinburgh, UK. Chad.Hemady@ed.ac.uk. Department of Psychology, University of Edinburgh, Edinburgh, UK. Social Work Department, University of Edinburgh, Edinburgh, UK. Moray House School of Education and Sport, University of Edinburgh, Edinburgh, UK. Faculty of Health, Queensland University of Technology, Brisbane, Australia. Department of Primary Care & Mental Health, University of Liverpool, Liverpool, UK. Child Protection Unit, University of the Philippines, Manila, Philippines. Department of Paediatrics, Faculty of Medicine, University of Kelaniya, Colombo, Sri Lanka. Caribbean Institute for Health Research, The University of the West Indies, Kingston, Jamaica. Australian Centre for Health Law Research, Queensland University of Technology, Brisbane, Australia. Centre for Family Research, University of Cambridge, Cambridge, UK. Department of Psychology, University of Ghana, Accra, Ghana. Department of Psychology, Babes-Bolyai University, Cluj-Napoca, Romania. Department of Psychology, University of Cape Town, Cape Town, South Africa. Institute for Community Health Research, Hue University, Hue, Vietnam. Division of Psychology & Language Sciences, University College London, London, UK. Department of Global Health, Institute of Life Course Health Research, Stellenbosch University, Cape Town, South Africa. Institute of Criminology, University of Cambridge, Cambridge, UK.

Abstract summary 

This paper enumerates and characterizes latent classes of adverse childhood experiences and investigates how they relate to prenatal substance use (i.e., smoking, alcohol, and other drugs) and poor infant outcomes (i.e., infant prematurity and low birthweight) across eight low- and middle-income countries (LMICs).A total of 1189 mother-infant dyads from the Evidence for Better Lives Study cohort were recruited. Latent class analysis using the Bolck, Croon, and Hagenaars (BCH) 3-step method with auxiliary multilevel logistic regressions was performed.Three high-risk classes and one low-risk class emerged: (1) highly maltreated (7%, n = 89), (2) emotionally and physically abused with intra-familial violence exposure (13%, n = 152), (3), emotionally abused (40%, n = 474), and (4) low household dysfunction and abuse (40%, n = 474). Pairwise comparisons between classes indicate higher probabilities of prenatal drug use in the highly maltreated and emotionally abused classes compared with the low household dysfunction and abuse class. Additionally, the emotionally and physically abused with intra-familial violence exposure class had higher probability of low birthweight than the three remaining classes.Our results highlight the multifaceted nature of ACEs and underline the potential importance of exposure to childhood adversities on behaviors and outcomes in the perinatal period. This can inform the design of antenatal support to better address these challenges.

Authors & Co-authors:  Hemady Chad Lance CL Speyer Lydia Gabriela LG Murray Aja Louise AL Brown Ruth Harriet RH Meinck Franziska F Fry Deborah D Do Huyen H Sikander Siham S Madrid Bernadette B Fernando Asvini A Walker Susan S Dunne Michael M Foley Sarah S Hughes Claire C Osafo Joseph J Baban Adriana A Taut Diana D Ward Catherine L CL Van Thang Vo V Fearon Pasco P Tomlinson Mark M Valdebenito Sara S Eisner Manuel M

Study Outcome 

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Statistics
Citations :  Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. Am J Prev Med. 1998;14(4):245–258. doi: 10.1016/S0749-3797(98)00017-8.
Authors :  23
Identifiers
Doi : 505
SSN : 1471-2393
Study Population
Male,Female
Mesh Terms
Adverse Childhood Experiences
Other Terms
Adverse childhood experiences;Intergenerational transmission of adversity;Latent class analysis;Maternal health;Neonatal health;Prenatal substance use
Study Design
Study Approach
Country of Study
Publication Country
England