School of Public Health, Brown University, Providence, Rhode Island, USA.
Rhode Island Department of Health, Providence, Rhode Island, USA.
Matern Child Health J. 2024 Oct;28(10):1749-1759. doi: 10.1007/s10995-024-03976-6. Epub 2024 Aug 16.
Adverse Childhood Experiences (ACEs) increase health risks leading to negative pregnancy outcomes, thus prompting the need for preconception care to address these risks. The aim of this study is to assess the association between ACEs score and self-report of having pre-pregnancy health conversations with a healthcare provider.
Secondary analysis of PRAMS data from 2016 to 2020 was performed from 3 states and Washington, DC. ACEs score was categorized as 0 (low risk), 1-3 (intermediate risk), and ≥ 4 (high risk). Pre-pregnancy health conversations were measured using reports of being asked about the desire to have children, use birth control to prevent pregnancy, and/or improve health during any visit in the 12 months prior to pregnancy. Multivariate Poisson Regression was performed to adjust for potential confounders: age, race/ethnicity, income, education, insurance type, marital status, pregnancy intention, and parity.
A total of 10,448 PRAMS survey responses from 2016 to 2020 were included in the analysis. More than half of women reported having at least 1 ACE (51%). Those with an ACE score of ≥ 4 had 1.19 (95% CI: 1.01-1.41) times higher adjusted Prevalence Ratio (aPR) and those with an ACE score of 1-3 had about the same aPR 1.00 (95% CI: 0.93-1.09) of reporting pre-pregnancy health conversations with a healthcare provider compared to those with no ACEs. CONCLUSIONS FOR PRACTICE: The overall low percentage of respondents reporting receipt of pre-pregnancy health conversations with a health care provider indicates the need for these conversations to be had on a more routine basis.
不良童年经历（ACEs）会增加健康风险，导致不良的妊娠结局，因此需要进行孕前保健以解决这些风险。本研究旨在评估 ACE 评分与报告与医疗保健提供者进行孕前健康对话之间的关联。
对来自 3 个州和华盛顿特区的 2016 年至 2020 年 PRAMS 数据进行二次分析。ACE 评分分为 0（低风险）、1-3（中风险）和≥4（高风险）。孕前健康对话是通过报告在怀孕前 12 个月内的任何就诊中被询问生育意愿、使用避孕药具避孕和/或改善健康状况来衡量的。采用多变量泊松回归调整潜在混杂因素：年龄、种族/民族、收入、教育程度、保险类型、婚姻状况、妊娠意向和产次。
纳入了 2016 年至 2020 年的 10448 份 PRAMS 调查回复，进行了分析。超过一半的女性报告至少有 1 项 ACE（51%）。ACE 评分≥4 的女性调整后患病率比（aPR）为 1.19（95%CI：1.01-1.41），而 ACE 评分 1-3 的女性与无 ACE 的女性报告与医疗保健提供者进行孕前健康对话的 aPR 约为 1.00（95%CI：0.93-1.09）。
总体而言，报告接受医疗保健提供者进行孕前健康对话的受访者比例较低，这表明需要更常规地进行这些对话。
