Maternal adverse childhood experiences and antepartum risks: the moderating role of social support

  • Nicole Racine
  • Sheri Madigan
  • Andre Plamondon
  • Erin Hetherington
  • Sheila McDonald
  • Suzanne Tough
Original Article

Abstract

The aims of the current study were to examine the association between maternal adverse childhood experiences (ACEs) and antepartum health risks, and to investigate whether social support moderated this association. It was hypothesized that ACEs would be associated with antepartum health risks; however, social support in the prenatal period would buffer mothers from the deleterious consequences of ACEs. Data from 1994 women (mean age = 31 years) and their infants were collected from a longitudinal cohort recruited in health care offices in Alberta, Canada. Pregnant women completed questionnaires related to ACEs prior to the age of 18 and prenatal social support, and a health care professional assessed the mother’s antepartum health risk. ACEs included physical, emotional, and sexual abuse, exposure to domestic violence, as well as exposure to household dysfunction such as parental substance use, mental illness, or incarceration. Regression analyses demonstrated a positive association between ACEs and antepartum health risks. However, a significant interaction between maternal ACEs and social support was also observed. Specifically, women exposed to high ACEs and low social support in pregnancy had high antepartum health risks. However, among mothers who had high ACEs but also high levels of social support, there was no association between ACEs and antepartum health risk. A history of ACEs can place mothers at risk of antepartum health complications. However, a resiliency effect was observed: women with a history of ACEs were buffered from experiencing antepartum health risks if they reported high levels of social support in pregnancy.

Keywords

Adverse child experiences Pregnancy Social support Reproductive health 

Notes

Acknowledgements

We would like to thank the families and children who participated in our study.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

  1. Alder J, Fink N, Bitzer J, Hosli I, Holzgreve W (2007) Depression and anxiety during pregnancy: a risk factor for obstetric, fetal and neonatal outcome? A critical review of the literature. J Matern Fetal Neonatal Med 20(3):189–209CrossRefPubMedGoogle Scholar
  2. Anda RF, Felitti VJ, Bremner JD, Walker JD, Whitfield C, Perry BD, Dube SR, Giles WH (2006) The enduring effects of abuse and related adverse experiences in childhood. A convergence of evidence from neurobiology and epidemiology. Eur Arch Psychiatry Clin Neurosci 256(3):174–186CrossRefPubMedGoogle Scholar
  3. Atkinson L, Beitchman J, Gonzalez A, Young A, Wilson B, Escobar M, Chisholm V, Brownlie E, Khoury JE, Ludmer J, Villani V (2015) Cumulative risk, cumulative outcome: a 20-year longitudinal study. PLoS One 10(6):e0127650CrossRefPubMedCentralPubMedGoogle Scholar
  4. Beijers R, Jansen J, Riksen-Walraven M, de Weerth C (2010) Maternal prenatal anxiety and stress predict infant illnesses and health complaints. Pediatrics 126(2):e401–e409CrossRefPubMedGoogle Scholar
  5. Bellis MA, Lowey H, Leckenby N, Hughes K, Harrison D (2014) Adverse childhood experiences: retrospective study to determine their impact on adult health behaviours and health outcomes in a UK population. J Public Health (Oxf) 36(1):81–91CrossRefGoogle Scholar
  6. Cham H, Baraldi AN, Enders CK (2013) Abstract: applying maximum likelihood estimation and multiple imputation to moderated regression models with incomplete predictor variables. Multivariate Behav Res 48(1):153–154CrossRefPubMedCentralPubMedGoogle Scholar
  7. Coburn SS, Gonzales NA, Luecken LJ, Crnic KA (2016) Multiple domains of stress predict postpartum depressive symptoms in low-income Mexican American women: the moderating effect of social support. Arch Womens Ment Health 19(6):1–10CrossRefGoogle Scholar
  8. Cohen S, Wills TA (1985) Stress, social support, and the buffering hypothesis. Psychol Bull 98(2):310–357CrossRefPubMedGoogle Scholar
  9. Delgado-Rodriguez M, Llorca J (2004) Bias. J Epidemiol Community Health 58(8):635–641CrossRefPubMedCentralPubMedGoogle Scholar
  10. Denis A, Michaux P, Callahan S (2012) Factors implicated in moderating the risk for depression and anxiety in high risk pregnancy. J Reprod Infant Psychol 30(2):124–134CrossRefGoogle Scholar
  11. Divon MY, Haglund B, Nisell H, Otterblad PO, Westgren M (1998) Fetal and neonatal mortality in the postterm pregnancy: the impact of gestational age and fetal growth restriction. Am J Obstet Gynecol 178(4):726–731CrossRefPubMedGoogle Scholar
  12. Dube SR, Felitti VJ, Dong M, Giles WH, Anda RF (2003) The impact of adverse childhood experiences on health problems: evidence from four birth cohorts dating back to 1900. Prev Med 37(3):268–277CrossRefPubMedGoogle Scholar
  13. Dunkel Schetter C (2011) Psychological science on pregnancy: stress processes, biopsychosocial models, and emerging research issues. Annu Rev Psychol 62:531–558CrossRefPubMedGoogle Scholar
  14. Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss MP, Marks JS (1998) Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) study. Am J Prev Med 14(4):245–258CrossRefPubMedGoogle Scholar
  15. Folger AT, Putnam KT, Putnam FW, Peugh JL, Eismann EA, Sa T, Shapiro RA, Van Ginkel JB, Ammerman RT (2017) Maternal interpersonal trauma and child social-emotional development: an intergenerational effect. Paediatr Perinat Epidemiol 31(2):99–107CrossRefPubMedGoogle Scholar
  16. Font SA, Maguire-Jack K (2016) Pathways from childhood abuse and other adversities to adult health risks: the role of adult socioeconomic conditions. Child Abuse Negl 51:390–399CrossRefPubMedGoogle Scholar
  17. Fraser AM, Brockert JE, Ward RH (1995) Association of young maternal age with adverse reproductive outcomes. N Engl J Med 332(17):1113–1117CrossRefPubMedGoogle Scholar
  18. Giesbrecht GF, Poole JC, Letourneau N, Campbell T, Kaplan BJ, A. P. S. Team (2013) The buffering effect of social support on hypothalamic-pituitary-adrenal axis function during pregnancy. Psychosom Med 75(9):856–862CrossRefPubMedGoogle Scholar
  19. Graham JW (2009) Missing data analysis: making it work in the real world. Annu Rev Psychol 60:549–576CrossRefPubMedGoogle Scholar
  20. Hardt J, Rutter M (2004) Validity of adult retrospective reports of adverse childhood experiences: review of the evidence. J Child Psychol Psychiatry 45(2):260–273CrossRefPubMedGoogle Scholar
  21. Hassan E (2005) Recall bias can be a threat to retrospective and prospective research designs. Internet J Epidemiol 3(2):1–7Google Scholar
  22. Hetherington E, Doktorchik C, Premji SS, McDonald SW, Tough SC, Sauve RS (2015) Preterm birth and social support during pregnancy: a systematic review and meta-analysis. Paediatr Perinat Epidemiol 29(6):523–535CrossRefPubMedGoogle Scholar
  23. Kahn RS, Zuckerman B, Bauchner H, Homer CJ, Wise PH (2002) Women's health after pregnancy and child outcomes at age 3 years: a prospective cohort study. Am J Public Health 92(8):1312–1318CrossRefPubMedCentralPubMedGoogle Scholar
  24. Larson CP (2007) Poverty during pregnancy: its effects on child health outcomes. Paediatr Child Health 12(8):673–677CrossRefPubMedCentralPubMedGoogle Scholar
  25. Leeners B, Stiller R, Block E, Gorres G, Rath W (2010) Pregnancy complications in women with childhood sexual abuse experiences. J Psychosom Res 69(5):503–510CrossRefPubMedGoogle Scholar
  26. Logan-Greene P, Green S, Nurius PS, Longhi D (2014) Distinct contributions of adverse childhood experiences and resilience resources: a cohort analysis of adult physical and mental health. Soc Work Health Care 53(8):776–797CrossRefPubMedCentralPubMedGoogle Scholar
  27. Madigan S, Wade M, Plamondon A, Maguire JL, Jenkins JM (2017) Maternal adverse childhood experience and infant health: biomedical and psychosocial risks as intermediary mechanisms. J Pediatr 187:282–289 e281CrossRefPubMedGoogle Scholar
  28. Martin JA, Hamilton BE, Osterman MJ, Driscoll AK, Mathews TJ (2017) Births: final data for 2015. Natl Vital Stat Rep 66(1):1PubMedGoogle Scholar
  29. Martin JA, Hamilton BE, Ventura SJ, Osterman MJ, Mathews TJ (2013) Births: final data for 2011. Natl Vital Stat Rep 62(1):1–69 72Google Scholar
  30. Mathews TJ, MacDorman MF (2013) Infant mortality statistics from the 2009 period linked birth/infant death data set. Natl Vital Stat Rep 61(8):1–27PubMedGoogle Scholar
  31. McDonald SW, Lyon AW, Benzies KM, McNeil DA, Lye SJ, Dolan SM, Pennell CE, Bocking AD, Tough SC (2013) The All Our Babies pregnancy cohort: design, methods, and participant characteristics. BMC Pregnancy Childbirth 13(Suppl 1):S2CrossRefPubMedCentralPubMedGoogle Scholar
  32. McDonnell CG, Valentino K (2016) Intergenerational effects of childhood trauma: evaluating pathways among maternal ACEs, perinatal depressive symptoms, and infant outcomes. Child Maltreat 21(4):317–326CrossRefGoogle Scholar
  33. McEwen BS, Stellar E (1993) Stress and the individual. Mechanisms leading to disease. Arch Intern Med 153(18):2093–2101CrossRefPubMedGoogle Scholar
  34. Narayan AJ, Rivera LM, Bernstein RE, Harris WW, Lieberman AF (2018) Positive childhood experiences predict less psychopathology and stress in pregnant women with childhood adversity: a pilot study of the benevolent childhood experiences (BCEs) scale. Child Abuse Negl 78:19–30CrossRefPubMedGoogle Scholar
  35. Parboosingh IJ (1986) The role of standardized risk assessment in the provision of prenatal care. Can Fam Physician 32:2115–2120PubMedCentralPubMedGoogle Scholar
  36. Patten SB, Wilkes TC, Williams JV, Lavorato DH, El-Guebaly N, Schopflocher D, Wild C, Colman I, Bulloch AG (2015) Retrospective and prospectively assessed childhood adversity in association with major depression, alcohol consumption and painful conditions. Epidemiol Psychiatr Sci 24(2):158–165CrossRefPubMedGoogle Scholar
  37. Program APH (2009) Delivery record—part one: antenatal risk assessment. from http://aphp.dapasoft.com/PublicHTML/doc/ABDelRecHS0001-126-1.pdf
  38. Racine N, Madigan S, Plamondon A, McDonald S, Tough S (2018a) Differential associations of adverse childhood experience on maternal health. Am J Prev Med 54:368–375CrossRefPubMedGoogle Scholar
  39. Racine N, Plamondon A, Madigan S, McDonald S, Tough S (2018b) Maternal adverse childhood experiences and infant development. PediatricsGoogle Scholar
  40. Rising SS (1998) Centering pregnancy. An interdisciplinary model of empowerment. J Nurse Midwifery 43(1):46–54CrossRefPubMedGoogle Scholar
  41. Roberts AL, Lyall K, Rich-Edwards JW, Ascherio A, Weisskopf MG (2013) Association of maternal exposure to childhood abuse with elevated risk for autism in offspring. JAMA Psychiatry 70(5):508–515CrossRefPubMedCentralPubMedGoogle Scholar
  42. Sherbourne CD, Stewart AL (1991) The MOS social support survey. Soc Sci Med 32(6):705–714CrossRefPubMedGoogle Scholar
  43. Smith MV, Gotman N, Yonkers KA (2016) Early childhood adversity and pregnancy outcomes. Matern Child Health J 20(4):790–798CrossRefPubMedCentralPubMedGoogle Scholar
  44. Young AF, Powers JR, Bell SL (2006) Attrition in longitudinal studies: who do you lose? Aust N Z J Public Health 30(4):353–361CrossRefPubMedGoogle Scholar
  45. Yuan K, Bentler PM (2000) Three likelihood-based methods for mean and covariance structure analysis with nonnormal missing data. Sociol Methodol 30(1):165–200CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2018

Authors and Affiliations

  • Nicole Racine
    • 1
  • Sheri Madigan
    • 2
  • Andre Plamondon
    • 3
  • Erin Hetherington
    • 4
  • Sheila McDonald
    • 4
  • Suzanne Tough
    • 5
  1. 1.Department of Psychology, Faculty of ArtsUniversity of CalgaryCalgaryCanada
  2. 2.Department of Psychology, Faculty of Arts, Alberta Children’s Hospital Research InstituteUniversity of CalgaryCalgaryCanada
  3. 3.Département des Fondements et Pratiques en ÉducationPavillon des Sciences de l’éducationQuébecCanada
  4. 4.Department of Community Health SciencesUniversity of CalgaryCalgaryCanada
  5. 5.Department of Community Health Sciences, Department of PediatricsUniversity of CalgaryCalgaryCanada

Personalised recommendations