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Maternal adverse childhood experiences and their association with preterm birth: secondary analysis of data from universal health visiting
BACKGROUND: Being born before full gestation can have short-term and life-long health implications, yet it remains difficult to determine the risk of preterm birth among expectant mothers. Across different health settings, increasing attention is given to the health and behavioural consequences of a...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8848970/ https://www.ncbi.nlm.nih.gov/pubmed/35172776 http://dx.doi.org/10.1186/s12884-022-04454-z |
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author | Hardcastle, Katie Ford, Kat Bellis, Mark A. |
author_facet | Hardcastle, Katie Ford, Kat Bellis, Mark A. |
author_sort | Hardcastle, Katie |
collection | PubMed |
description | BACKGROUND: Being born before full gestation can have short-term and life-long health implications, yet it remains difficult to determine the risk of preterm birth among expectant mothers. Across different health settings, increasing attention is given to the health and behavioural consequences of adverse childhood experiences (ACEs) such as child abuse or neglect, or exposure to harmful household environments (e.g. in which caregivers abuse alcohol), and the potential value of understanding these hidden harms when supporting individuals and families. A large international evidence base describes the association between childhood adversity and early years outcomes for mothers and children. However, the relationship between maternal ACEs and preterm birth has received far less attention. METHODS: Secondary analysis was carried out on anonymised cross-sectional data from health visiting services in south and west Wales that had previously captured information on mothers’ ACEs during routine contacts. Demographic data and information on mothers’ health were extracted from the Healthy Child Wales Programme. RESULTS: Half of all mothers sampled had experienced at least one ACE, with a history of ACEs more common among younger, white British mothers and those residing in deprived areas. Preterm birth was significantly independently associated with retrospective reports of childhood sexual abuse (adjusted odds ratio [AOR] = 3.83, 95% confidence interval [CI] = 1.19–12.32, p = 0.025), neglect (AOR = 7.60, 95%CI = 1.81–31.97, p = 0.006) and overall ACE exposure (AOR = 2.67, 95%CI = 1.14–6.23, p = 0.024), with one in ten mothers (10.0%) who experienced ≥4 ACEs having preterm birth. Sub-analyses revealed a more pronounced relationship among mothers with no known chronic health conditions, with those with ≥4 ACEs and no known chronic condition four times more likely to give birth preterm (AOR = 3.89, 95%CI = 1.40–10.80, p = 0.009). CONCLUSIONS: Findings highlight the importance of the entire maternal experience. The experience of childhood adversity can have a lasting impact into and beyond the prenatal period, potentially increasing the risk of preterm birth, even among otherwise healthy women. Increasing our understanding of the potential perinatal outcomes associated with ACEs can help to inform how maternity services and partners offer trauma-sensitive support to mitigate some of the risks of early parturition, as well as target intergenerational cycles of adversity and poor health. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12884-022-04454-z. |
format | Online Article Text |
id | pubmed-8848970 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-88489702022-02-18 Maternal adverse childhood experiences and their association with preterm birth: secondary analysis of data from universal health visiting Hardcastle, Katie Ford, Kat Bellis, Mark A. BMC Pregnancy Childbirth Research BACKGROUND: Being born before full gestation can have short-term and life-long health implications, yet it remains difficult to determine the risk of preterm birth among expectant mothers. Across different health settings, increasing attention is given to the health and behavioural consequences of adverse childhood experiences (ACEs) such as child abuse or neglect, or exposure to harmful household environments (e.g. in which caregivers abuse alcohol), and the potential value of understanding these hidden harms when supporting individuals and families. A large international evidence base describes the association between childhood adversity and early years outcomes for mothers and children. However, the relationship between maternal ACEs and preterm birth has received far less attention. METHODS: Secondary analysis was carried out on anonymised cross-sectional data from health visiting services in south and west Wales that had previously captured information on mothers’ ACEs during routine contacts. Demographic data and information on mothers’ health were extracted from the Healthy Child Wales Programme. RESULTS: Half of all mothers sampled had experienced at least one ACE, with a history of ACEs more common among younger, white British mothers and those residing in deprived areas. Preterm birth was significantly independently associated with retrospective reports of childhood sexual abuse (adjusted odds ratio [AOR] = 3.83, 95% confidence interval [CI] = 1.19–12.32, p = 0.025), neglect (AOR = 7.60, 95%CI = 1.81–31.97, p = 0.006) and overall ACE exposure (AOR = 2.67, 95%CI = 1.14–6.23, p = 0.024), with one in ten mothers (10.0%) who experienced ≥4 ACEs having preterm birth. Sub-analyses revealed a more pronounced relationship among mothers with no known chronic health conditions, with those with ≥4 ACEs and no known chronic condition four times more likely to give birth preterm (AOR = 3.89, 95%CI = 1.40–10.80, p = 0.009). CONCLUSIONS: Findings highlight the importance of the entire maternal experience. The experience of childhood adversity can have a lasting impact into and beyond the prenatal period, potentially increasing the risk of preterm birth, even among otherwise healthy women. Increasing our understanding of the potential perinatal outcomes associated with ACEs can help to inform how maternity services and partners offer trauma-sensitive support to mitigate some of the risks of early parturition, as well as target intergenerational cycles of adversity and poor health. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12884-022-04454-z. BioMed Central 2022-02-16 /pmc/articles/PMC8848970/ /pubmed/35172776 http://dx.doi.org/10.1186/s12884-022-04454-z Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Hardcastle, Katie Ford, Kat Bellis, Mark A. Maternal adverse childhood experiences and their association with preterm birth: secondary analysis of data from universal health visiting |
title | Maternal adverse childhood experiences and their association with preterm birth: secondary analysis of data from universal health visiting |
title_full | Maternal adverse childhood experiences and their association with preterm birth: secondary analysis of data from universal health visiting |
title_fullStr | Maternal adverse childhood experiences and their association with preterm birth: secondary analysis of data from universal health visiting |
title_full_unstemmed | Maternal adverse childhood experiences and their association with preterm birth: secondary analysis of data from universal health visiting |
title_short | Maternal adverse childhood experiences and their association with preterm birth: secondary analysis of data from universal health visiting |
title_sort | maternal adverse childhood experiences and their association with preterm birth: secondary analysis of data from universal health visiting |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8848970/ https://www.ncbi.nlm.nih.gov/pubmed/35172776 http://dx.doi.org/10.1186/s12884-022-04454-z |
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