Adverse childhood experiences are associated with illicit drug use among pregnant women with middle to high socioeconomic status: findings from the All Our Families Cohort

Abstract

Background Adverse childhood experiences (ACEs) are associated with illicit drug use among pregnant women who are socioeconomically vulnerable. While it is assumed that the impact of ACEs on illicit drug use in pregnancy is reduced among women with higher socioeconomic status (SES), this assumption is not well tested in the literature. The objective of this study was to examine the impact of maternal ACEs on illicit drug use in a community-based sample of pregnant women with middle to high SES. Methods This study is a secondary analysis of a prospective cohort study that collected data from 1660 women during and after pregnancy in Calgary, Canada between 2008 and 2011 using mailed surveys. Illicit drug use in pregnancy was self-reported by women at 34–36 weeks gestation. An established scale examined maternal ACEs before 18 years. Logistic regression models and 95% confidence intervals tested associations between maternal ACE scores and illicit drug use in pregnancy. Results Overall, 3.1% of women in this predominantly married, well-educated, middle and upper middle income sample reported illicit drug use in pregnancy. Women with 2–3 ACEs had more than a two-fold increase, and women with 4 or more ACEs had almost a four-fold increase in illicit drug use in pregnancy, relative to women with 0–1 ACEs after adjustment for confounders. Exposure to child abuse was more consistently associated with illicit drug use in pregnancy than exposure to household dysfunction in childhood. Conclusions Maternal ACEs were common and associated with a moderate increase in the odds of illicit drug use in pregnancy among Canadian women with middle to high SES.

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

“…The copyright holder for this preprint this version posted July 29, 2021. ; https://doi.org/10.1101/2021.07.23.21261027 doi: medRxiv preprint Prenatal illicit drug use was present in 6% of the study sample which is comparable to other ACE studies involving a cohort of pregnant women residing in HIC (3.1%) (see Racine et al, 2018). Multilevel logistic regressions suggested that, more broadly, there is low probability of prenatal illicit drug use across the different classes; these findings are inconsistent with previous research that suggest a dose-response relationship between maternal ACEs and prenatal illicit drug use (Currie & Tough, 2021). However, the pairwise differences between classes suggest that the highly maltreated class and the emotionally abused class, but not the intra-familial violence exposed class, had greater probability of prenatal illicit drug use compared to the normative class.…”

“…The findings suggested high prevalence and co-occurrence of maternal ACEs in this cohort, with 39% having experienced ≥ 4 ACEs which is higher compared to other ACE studies involving a cohort of pregnant women in HICs (14.1% and 14.7%, respectively). (see Currie & Tough, 2021). A model with four distinct latent classes was judged optimal for these data, with classes labelled: the highly maltreated class (7%), the emotionally and physically abused with intra-familial violence exposure class (13%), the emotionally abused class (40%), and the low household dysfunction and abuse class (40%).…”

Socioeconomic Status Moderates the Impact of Emotional but not Physical Childhood Abuse on Women’s Sleep

“…Associations were adjusted for covariates selected a priori from the literature including age, marital status, the number of children a participant had, and their current adult income group (Kajeepeta et al, 2015). Mental health and health behaviour covariates were not included in models given the impacts of childhood trauma on mental health and behaviour are well documented across studies (Afifi et al, 2014;Currie, 2006;Currie & Tough, 2021;Petersen et al, 2014). Thus, controlling for mental health variables, which likely sit on the causal pathway between child abuse and adult sleep, would result in biased estimates.…”

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

“…Using the Evidence for Better Lives Study (EBLS) dataset, the number and characterizations of latent ACEs and their associations with prenatal substance use and poor infant outcomes were explored. The findings suggested high prevalence and co-occurrence of maternal ACEs in this cohort, with 39% having experienced ≥ 4 ACEs which is higher than in ACE studies involving pregnant women in HICs [ 29 ].…”