Given the importance of early prevention and intervention strategies for children exposed to trauma, detection of early risk factors for exposure to traumatic events in childhood is critical. The present study examined associations between three known prenatal risk factors that characterize environmental instability in utero-prenatal substance exposure, prenatal violence victimization, and unintended pregnancy-and child exposure to interparental violence and other adverse experiences in a sample of 198 mother-child dyads (M child age = 44.48 months) referred to a hospital clinic for treatment following exposure to trauma. Prenatal substance and violence exposure were associated with child trauma exposure, and prenatal violence victimization was also associated with maternal severity ratings of traumatic exposures. Unintended pregnancy was not associated with child trauma exposure or severity. These findings expand our understanding of prenatal risk factors for trauma exposure in childhood and, specifically, highlight prenatal substance exposure and violence victimization as risk factors for subsequent exposure to trauma in early childhood. Results suggest that prenatal prevention and intervention programs should target reducing maternal substance use and in-utero exposure to violence.