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

Hemady, Chad Lance and Speyer, Lydia Gabriela and Murray, Aja Louise and Brown, Ruth Harriet and Meinck, Franziska and Fry, Deborah and Do, Huyen and Sikander, Siham and Madrid, Bernadette and Fernando, Asvini and Walker, Susan and Dunne, Michael and Foley, Sarah and Hughes, Claire and Osafo, Joseph and Baban, Adriana and Taut, Diana and Ward, Catherine L and Van Thang, Vo and Fearon, Pasco and Tomlinson, Mark and Valdebenito, Sara and Eisner, Manuel (2022) 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. BMC Pregnancy and Childbirth, 22 (1): 505. p. 505. ISSN 1471-2393

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Abstract

BACKGROUND: This paper enumerates and characterizes latent classes of adverse childhood experiences and investigates how they relate to prenatal substance use (i.e., smoking, alcohol, and other drugs) and poor infant outcomes (i.e., infant prematurity and low birthweight) across eight low- and middle-income countries (LMICs). METHODS: A total of 1189 mother-infant dyads from the Evidence for Better Lives Study cohort were recruited. Latent class analysis using the Bolck, Croon, and Hagenaars (BCH) 3-step method with auxiliary multilevel logistic regressions was performed. RESULTS: Three high-risk classes and one low-risk class emerged: (1) highly maltreated (7%, n = 89), (2) emotionally and physically abused with intra-familial violence exposure (13%, n = 152), (3), emotionally abused (40%, n = 474), and (4) low household dysfunction and abuse (40%, n = 474). Pairwise comparisons between classes indicate higher probabilities of prenatal drug use in the highly maltreated and emotionally abused classes compared with the low household dysfunction and abuse class. Additionally, the emotionally and physically abused with intra-familial violence exposure class had higher probability of low birthweight than the three remaining classes. CONCLUSION: Our results highlight the multifaceted nature of ACEs and underline the potential importance of exposure to childhood adversities on behaviors and outcomes in the perinatal period. This can inform the design of antenatal support to better address these challenges.