Department of Psychology, Faculty of Arts, University of Calgary, Alberta Children's Hospital Research Institute, 2500 University Dr. NW, Calgary, AB T2N 1N4, Canada.
Department of Community Health Sciences, Department of Pediatrics, University of Calgary, 2500 University Dr. NW, Calgary, AB T2N 1N4, Canada.
Prev Med. 2020 Dec;141:106303. doi: 10.1016/j.ypmed.2020.106303. Epub 2020 Oct 26.
Substance use in pregnancy, including alcohol use, drug use, or smoking, is associated with poor health outcomes for both the mother and her unborn child. Building on previous research that has examined the cumulative impact of Adverse Childhood Experiences (ACEs) on maternal binge drinking and alcohol use in pregnancy, the current study sought to examine the association between maternal ACEs and substance use in pregnancy more broadly, including alcohol use, binge drinking, smoking, and drug use. Furthermore, we also examined how different adversity subtypes, including sexual abuse, family violence (physical abuse, emotional abuse), and household dysfunction, differentially predict maternal substance use behavior. A sample of 1994 women were recruited between 2008 and 2011 from a community-based pregnancy cohort in Calgary, Canada. Self-reported information on exposure to ACEs prior to the age of 18 years and maternal substance usewere collected. Examining ACE subtypes, medium effects were observed for the role of household-dysfunction on binge drinking, drug use, and smoking in pregnancy, while only small effects were observed for family violence on binge drinking, drug use, and smoking. There were no significant effects for sexual abuse after controlling for covariates. A dose-response association between the number of ACEs and substance use in pregnancy was also demonstrated. Increased support prior to, and in pregnancy, particularly for women with a history of childhood adversity, is needed to reduce substance use behaviors in pregnancy.
怀孕期间的物质使用，包括饮酒、吸毒或吸烟，会对母亲和她未出生的孩子的健康产生不良影响。本研究在前人研究的基础上，进一步考察了童年期逆境经历（ACEs）对母亲 binge drinking 和孕期饮酒的累积影响，旨在更广泛地探讨母亲 ACEs 与孕期物质使用之间的关系，包括饮酒、 binge drinking、吸烟和吸毒。此外，我们还研究了不同类型的逆境，包括性虐待、家庭暴力（身体虐待、情感虐待）和家庭功能障碍，如何不同程度地预测母亲的物质使用行为。研究样本为 1994 名女性，于 2008 年至 2011 年期间在加拿大卡尔加里的一个社区为基础的妊娠队列中招募。收集了这些女性在 18 岁之前接触 ACEs 的自我报告信息以及孕期物质使用情况。考察 ACE 亚型后发现，家庭功能障碍对孕期 binge drinking、吸毒和吸烟的影响具有中等效应，而家庭暴力对 binge drinking、吸毒和吸烟的影响则较小。在控制了协变量后，性虐待对 binge drinking、吸毒和吸烟的影响没有统计学意义。此外，还证明了 ACEs 数量与孕期物质使用之间存在剂量反应关系。在怀孕前和怀孕期间，特别是对于有童年期逆境经历的女性，需要增加支持，以减少孕期的物质使用行为。
