94 Maternal Adverse Childhood Experiences (ACEs) and child development at 5 years

Abstract

BACKGROUND: Adverse childhood experiences (ACEs) can have an impact on the health and well-being of individuals throughout life. Adults with a history of ACEs who become parents may experience parenting difficulties and face challenges in building supportive environments which can influence child development. OBJECTIVE(S): To examine the impact of maternal adversity on child development at five years, and what factors may promote resiliency among children at high risk. DESIGN/METHODS: Participants include 1992 mothers and children participating in a community-based longitudinal cohort in an urban setting in Canada. Mothers completed questionnaires regarding their own ACEs, mental health, parenting and personality and child outcomes. Child externalizing and internalizing behaviour was measured using the Behavioural Assessment Scale for Children -2 (BASC-2). Multivariable logistic regression models were used to estimate risk and protective factors for internalizing and externalizing behaviour among children at 5 years. A resilience analysis among children whose mothers had four or more ACEs was carried out examining the effect of potential protective factors including maternal optimism, social support, and use of community supports and childcare controlling for known risk factors. RESULT(S): Sixteen percent of children scored at risk for internalizing behaviours. Maternal ACES were not associated with internalizing behaviours, however, risk factors included persistent maternal mental health symptoms (OR 1.80 95% CI 1.18, 2.74), maternal neuroticism (OR 2.23 95% CI 1.56, 3.18) and hostile parenting practices (OR 1.51 95% CI 1.08, 2.23). Children of women who worked or were students had reduced odds of internalizing behaviours (OR 0.73 95% CI 0.55, 0.98). Eleven percent of children scored at risk for externalizing behaviours. Maternal ACEs were associated with a 2.30 increased odds of externalizing behaviours (95% CI 1.50, 3.51). Additional risk factors included persistent maternal mental health symptoms, and hostile parenting practices. Male children were also at an increased risk of externalizing problems (OR 2.58 95% CI 1.76, 3.77). Among children with mothers who had high ACEs, high levels of social support was protective against internalizing behaviours, but not externalizing behaviours. CONCLUSION(S): While maternal ACEs may impact certain aspects of child development, maternal psychosocial health has the potential to be a less stigmatizing indicator of risk. Strategies to support parents through targeting modifiable factors, and supporting mental health wellbeing can help optimize child development in the next generation.