142nd APHA Annual Meeting and Exposition

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Impact of Adverse Childhood Experiences on Drinking Before and During Pregnancy

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 3:30 PM - 3:50 PM

David Frankenberger, MPH (c) , School of Community Health Sciences, University of Nevada, Reno, Reno, CA
Kristen Clements-Nolle, PhD, MPH , School of Community Health Sciences, University of Nevada, Reno, Reno, NV
Wei Yang, PhD, MD , School of Community Health Sciences, University of Nevada Reno, Reno, NV
Audio (mp3) recording Recorded Presentation (mp4)
Background: The impact of adverse childhood experiences (ACEs) on adult alcohol consumption is well-established, but little is known about the impact on drinking before and during pregnancy. 

Methods: Using data from the 2010 Nevada Behavioral Risk Factor Surveillance System (BRFSS), we assessed the relationship between ACES and alcohol use the month before pregnancy (n=1523) and during pregnancy (n=1634). The BRFSS ACE scale was used to assess childhood physical, emotional, and sexual abuse and household dysfunction (range 0-8).  Weighted logistic regression was conducted to assess the relationship between ACE scores and alcohol use the month before pregnancy and during pregnancy, after controlling for demographics.  

Results:  20.0% of participants reported drinking alcohol the month before pregnancy and 6.6% during pregnancy.  After controlling for age, race, and education, increasing ACE scores were associated with an increased odds of alcohol use before pregnancy (1 ACE: AOR=1.1; 95% CI= 0.61, 1.97), (2-3 ACEs: AOR=2.47; 95% CI=1.46, 4.19), and (4 or more ACEs: AOR=2.68; 95% CI=1.6, 4.52). An even stronger dose response relationship was observed for drinking during pregnancy (1 ACE: AOR=1.77; 95% CI= 0.80, 3.92), (2-3 ACEs: AOR=3.25; 95% CI=1.64, 6.45), and (4 or more ACEs: AOR=5.07; 95% CI=2.53, 10.15).

Conclusions:   Our results suggest that ACEs are a strong risk factor for drinking before and during pregnancy.  Screening for ACEs among women of childbearing age and pregnant women may be an effective strategy for identifying women who could benefit from substance abuse prevention and treatment.    

Learning Areas:

Social and behavioral sciences

Learning Objectives:
Identify factors contributing to alcohol use the month before and during pregnancy.

Keyword(s): Birth Defects, Birth Outcomes

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the principal investigator on two studies evaluating the impact of adverse childhood experiences on health outcomes and supervised the analysis for this presentation.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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