Racine Nicole, Byles Hannah, Killam Teresa, Ereyi-Osas Whitney, Madigan Sheri
Department of Psychology, University of Calgary, 2500 University Ave., Calgary, AB, T2N 1N4, Canada.
Alberta Children's Hospital Research Institute, 28 Oki Drive NW, Calgary, AB, T3B 6A8, Canada.
Matern Child Health J. 2022 May;26(5):994-1004. doi: 10.1007/s10995-021-03301-5. Epub 2021 Nov 27.
Adverse childhood experiences (ACEs) are associated with poor physical and mental health outcomes in pregnancy, prompting many care agencies to ask about ACEs as part of routine care. However, limited research has been conducted in the clinical setting to demonstrate associations between ACEs and maternal health (i.e., pregnancy complications and birth outcomes) and mental health in pregnancy (i.e., depression, anxiety, and substance use). The aims of the current study were to: (1) examine the prevalence of ACEs reported by patients attending a maternity clinic for medically low-risk patients, and (2) evaluate whether these reports were associated with prenatal health and mental health.
Participants included pregnant women (n = 338) receiving prenatal care at a low-risk outpatient medical clinical from June 2017 to December 2018. Total ACE scores, pregnancy complications (e.g., gestational hypertension, preeclampsia), birth outcomes (e.g., Apgar scores, preterm birth), and mental health outcomes (i.e., anxiety, depression, and substance use) were extracted from electronic medical records.
The majority of women (67.8%) reported experiencing no ACEs, 16.0% reported one ACE, 10.1% reported two ACEs, and 6.2% reported three or more ACEs. ACEs were associated with increased odds of prenatal depression, anxiety, and substance use in a dose-response fashion, but not pregnancy health or birth outcomes.
Prevalence rates of maternal ACEs obtained in the prenatal care setting were low compared to the general population. While ACEs were positively associated with maternal mental health and substance use in pregnancy, they were not associated with pregnancy complications.
童年不良经历（ACEs）与孕期不良身心健康结局相关，这促使许多医疗机构在常规护理中询问ACEs情况。然而，在临床环境中开展的研究有限，以证明ACEs与孕产妇健康（即妊娠并发症和分娩结局）以及孕期心理健康（即抑郁、焦虑和物质使用）之间的关联。本研究的目的是：（1）调查在产科诊所就诊的低风险孕妇报告的ACEs患病率，以及（2）评估这些报告是否与产前健康和心理健康相关。
研究对象包括2017年6月至2018年12月在一家低风险门诊医疗诊所接受产前护理的孕妇（n = 338）。从电子病历中提取ACEs总分、妊娠并发症（如妊娠期高血压、先兆子痫）、分娩结局（如阿氏评分、早产）以及心理健康结局（即焦虑、抑郁和物质使用）。
大多数女性（67.8%）报告未经历ACEs，16.0%报告经历了1次ACEs，10.1%报告经历了2次ACEs，6.2%报告经历了3次或更多次ACEs。ACEs与产前抑郁、焦虑和物质使用几率的增加呈剂量反应关系，但与妊娠健康或分娩结局无关。
在产前护理环境中获得的孕产妇ACEs患病率与一般人群相比偏低。虽然ACEs与孕期孕产妇心理健康和物质使用呈正相关，但与妊娠并发症无关。
