Early Childhood Adversity and Pregnancy Outcomes

Matern Child Health J. 2016 Apr;20(4):790-8. doi: 10.1007/s10995-015-1909-5.


Objectives: To examine the association between adverse childhood experiences (ACEs) and pregnancy outcomes; to explore mediators of this association including psychiatric illness and health habits.

Methods: Exposure to ACEs was determined by the Early Trauma Inventory Self Report Short Form; psychiatric diagnoses were generated by the Composite International Diagnostic Interview administered in a cohort of 2303 pregnant women. Linear regression and structural equation modeling bootstrapping approaches tested for multiple mediators.

Results: Each additional ACE decreased birth weight by 16.33 g and decreased gestational age by 0.063. Smoking was the strongest mediator of the effect on gestational age.

Conclusions: ACEs have an enduring effect on maternal reproductive health, as manifested by mothers' delivery of offspring that were of reduced birth weight and shorter gestational age.

Keywords: Adverse childhood experiences; Maternal mental health; Pregnancy outcomes; Smoking; Trauma.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Child, Preschool
  • Crime Victims / psychology*
  • Crime Victims / statistics & numerical data
  • Depressive Disorder, Major / diagnosis*
  • Depressive Disorder, Major / psychology
  • Female
  • Gestational Age
  • Humans
  • Life Change Events*
  • Massachusetts
  • Mothers / psychology*
  • Pregnancy
  • Pregnancy Outcome*
  • Premature Birth
  • Prospective Studies
  • Severity of Illness Index
  • Smoking
  • Socioeconomic Factors
  • Violence / psychology*
  • Violence / statistics & numerical data