Duka Shae, Rahman Sadeea, Hansen Susan E, Esernio-Jenssen Debra
Network Office of Research and Innovation, Lehigh Valley Health Network, Allentown, USA.
Morsani College of Medicine, University of South Florida, Tampa, USA.
Matern Child Health J. 2023 Dec;27(Suppl 1):153-165. doi: 10.1007/s10995-023-03768-4. Epub 2023 Sep 21.
To analyze adverse childhood experiences (ACEs) among mothers of newborns referred to a hospital's child protection team (CPT) for suspected substance exposure. Researchers hypothesized that a higher prevalence of these mothers have ≥ 4 ACEs than female counterparts in the general population. The study team also explored whether associations existed between type of maternal ACEs and substance use in pregnancy.
Retrospective review of infant referrals to the CPT in the 3 years after adding an ACEs questionnaire to the consultation process. Bivariate analyses and multivariate logistic regression models examined associations between prenatal substance use and maternal ACEs prevalence, controlling for demographics.
Data from 222 infants (four sets of twins) and 218 mothers were analyzed. Half (50.0%) the infants had withdrawal symptoms. Most (67.0%) women had positive toxicology screens, while 85.0% reported prenatal substance use. Half (50.9%) the mothers reported ≥ 4 ACEs and these individuals had significantly higher odds of cannabinoid use [adjusted odds ratio (aOR), 3.7; 95%CI 2.0, 6.9, p < 0.001) than those with < 4 ACEs. A significant association was found between substance use and ACEs in the household challenges category (p = 0.03), especially parental separation/divorce (p < 0.001).
As hypothesized, a higher prevalence of mothers referred to the CPT had ≥ 4 ACEs than women in the general population (50.9% vs. 15.2%), and a large proportion had used substances while pregnant. Routine prenatal ACEs screening and universal, nonpunitive toxicology testing of infants and mothers at birth may provide opportunities for intervention while reducing the transgenerational impact of ACEs.
分析因疑似接触毒品而被转介至医院儿童保护团队（CPT）的新生儿母亲的童年不良经历（ACEs）。研究人员推测，与普通人群中的女性相比，这些母亲中ACEs≥4种的比例更高。研究团队还探讨了母亲ACEs的类型与孕期吸毒之间是否存在关联。
在咨询过程中添加ACEs问卷后的3年里，对转介至CPT的婴儿进行回顾性研究。采用双变量分析和多变量逻辑回归模型，在控制人口统计学因素的情况下，研究产前吸毒与母亲ACEs患病率之间的关联。
分析了222名婴儿（四对双胞胎）和218名母亲的数据。一半（50.0%）的婴儿有戒断症状。大多数（67.0%）女性的毒理学筛查呈阳性，而85.0%的人报告在孕期吸毒。一半（50.9%）的母亲报告ACEs≥4种，与ACEs＜4种的母亲相比，这些人使用大麻的几率显著更高[调整后的优势比（aOR）为3.7；95%CI为2.0，6.9，p＜0.001]。在家庭挑战类别中，吸毒与ACEs之间存在显著关联（p = 0.03），尤其是父母分居/离婚（p＜0.001）。
正如所推测的那样，被转介至CPT的母亲中ACEs≥4种的比例高于普通人群中的女性（50.9%对15.2%），并且很大一部分人在孕期使用过毒品。常规的产前ACEs筛查以及对婴儿和母亲在出生时进行普遍的、非惩罚性的毒理学检测，可能会提供干预机会，同时减少ACEs的代际影响。
