The Association between Perinatal Complications and Adverse Childhood Experiences: Findings from a Nationwide Online Survey

Abstract

Objective This study aimed to evaluate the association between maternal adverse childhood experiences (ACEs) levels and the risk of perinatal complications. Study Design This is a retrospective cohort study of 5,693 mother-child pairs born between 2019 and 2021, who completed questionnaires on maternal ACE scores and perinatal complications such as preterm birth, low birth weight infants, pregnancy-induced hypertension (PIH), gestational diabetes mellitus (GDM), and premature rupture of membrane (PROM). Odds ratios (OR) and 95% confidence intervals (CI) were calculated using logistic regression according to the three ACE score groups after adjusting for confounding factors such as maternal age, child's sex, household income, and maternal education. Results Maternal ACEs have a significant positive correlation with preterm birth (OR: 1.42, 95% CI: 1.09-1.86, p for trend = 0.009), PIH (OR: 1.55, 95% CI: 1.17-2.07, p for trend = 0.002), and PROM (OR: 1.42, 95% CI: 1.09-1.84, p for trend = 0.01). These associations remained unchanged when stratified according to smoking, alcohol consumption, and obesity. Conclusion Maternal ACEs were associated with the risk of perinatal complications such as preterm birth, PIH, and PROM. Key Points Maternal ACEs are linked to higher risks of preterm birth, PIH, and PROM. Parental divorce, emotional abuse, and neglect were the most common ACEs among Japanese mothers. Mothers with ACEs score ≥ 2 had a higher risk of perinatal complications.