Patterns of adverse childhood experiences and associations with prenatal substance use and poor infant outcomes in a multi-country cohort of mothers: A latent class analysis

Chad Lance Hemady*, Lydia Gabriela Speyer, Ruth Harriet Brown, Aja Louise Murray, Franziska Meinck, Deborah Fry, Huyen Do, Siham Sikander, Bernadette Madrid, Asvini D Fernando, Susan Walker, Michael Dunne, Sarah Foley, Claire Hughes, Joseph Osafo, Adriana Baban, Diana Taut, Catherine L. Ward, Vo Van Thang, Pasco FearonMark Tomlinson, Sara Valdebenito, Manuel Eisner

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: This paper enumerates and characterizes latent classes of adverse childhood experiences and investigates how they relate to prenatal substance use (i.e., smoking, alcohol, and other drugs) and poor infant outcomes (i.e., infant prematurity and low birthweight) across eight low- and middle-income countries (LMICs).
Methods: A total of 1189 mother-infant dyads from the Evidence for Better Lives Study cohort were recruited. Latent class analysis using the Bolck, Croon, and Hagenaars (BCH) 3-step method with auxiliary multilevel logistic regressions was performed.
Results: Three high-risk classes and one low-risk class emerged: (1) highly maltreated (7%, n = 89), (2) emotionally and physically abused with intra-familial violence exposure (13%, n = 152), (3), emotionally abused (40%, n = 474), and (4) low household dysfunction and abuse (40%, n = 474). Pairwise comparisons between classes indicate higher probabilities of prenatal drug use in the highly maltreated and emotionally abused classes compared with the low household dysfunction and abuse class. Additionally, the emotionally and physically abused with intra-familial violence exposure class had higher probability of low birthweight than the three remaining classes.
Conclusion: Our results highlight the multifaceted nature of ACEs and underline the potential importance of exposure to childhood adversities on behaviors and outcomes in the perinatal period. This can inform the design of antenatal support to better address these challenges.
Original languageEnglish
Article number505 (2022)
Pages (from-to)1-12
Number of pages12
JournalBMC pregnancy and childbirth
Volume22
DOIs
Publication statusPublished - 22 Jun 2022

Keywords

  • adverse childhood experiences
  • latent class analysis
  • maternal health
  • neonatal health
  • prenatal substance use
  • intergenerational transmission of adversity

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