Association between adverse childhood experiences and pregnancy morbidities: A nationwide online-based cross-sectional study

Abstract

Objective

To examine the association between adverse childhood experiences (ACEs) and pregnancy morbidities, including preterm birth (PTB), gestational diabetes (GDM), preeclampsia, and small-for-gestational-age (SGA) among the general population in Japan.

Methods

The data were from the JACSIS study, an online-based nationwide survey conducted from July to August 2021 in Japan (N = 5444). ACEs included physical, sexual, and psychological abuse, neglect, childhood poverty, bully victimization, domestic violence, parental death, and parental divorce. Pregnancy morbidities, including PTB, GDM, preeclampsia, and SGA were identified through questionnaires. A multivariable logistic regression model was applied.

Results

Of 5444 women, 2778 (51.0%) had no ACEs, and 374 (6.9%) had four or more ACEs. A dose–response association was found between total ACE score and PTB and preeclampsia (p-value: 0.016 and 0.001). Women with four or more ACE scores showed higher risks of preeclampsia (adjusted odds ratio [aOR] [95% confidence interval, CI]: 3.06 [1.57–5.94], p-value: 0.001). Besides, those with two or three ACEs had higher risks of PTB (aOR [95%CI]: 1.42 [1.01–2.02], p-value: 0.046, and aOR [95%CI]: 1.61 [1.04–2.50], p-value: 0.041), and women with one ACE showed a higher risk of GDM (aOR [95%CI]: 1.34 [1.02–1.77], p-value: 0.035). SGA was not associated with ACEs.

Conclusion

ACEs were associated with an increased risk of PTB, preeclampsia, and GDM, but not SGA among the general population in Japan.