Adverse Childhood Experiences and Maternal Health Consequences: Variation by Race/Ethnicity

introduction:  Adverse childhood experiences (ACEs) have been linked to poor health in later life.  Less is known about earlier effects on maternal health or whether ACEs and their consequences vary by race/ethnicity. 

method:  This study examines a diverse sample of 677 low-income women receiving home visiting services in Wisconsin.  Respondents answered questions about childhood abuse and household dysfunction from the Behavioral Risk Factor Surveillance Survey along with additional questions about physical and emotional neglect.  Descriptive analyses provided prevalence estimates of ACEs, and multiple regressions tested associations between a summative 10-item ACE index and indicators of maternal health. 

results:  Results showed that 85% of participants endorsed at least one ACE.  Rates of sexual abuse and neglect were highest among African Americans.  Household substance abuse, mental illness, crime, and domestic violence rates were highest among American Indians.  Non-Hispanic Caucasians reported the highest rates of physical abuse, psychological abuse, and parental divorce/separation.  Compared to the balance of the sample, total ACE scores were significantly lower among Hispanics (p < .001) and higher among Caucasians (p < .001).  Higher ACE scores were associated with smoking during pregnancy (p = .001), perinatal depression scores on the Edinburgh Postnatal Depression Scale (p < .001), and lifetime pregnancy loss (p = .009).  Moderation tests revealed that associations did not vary by race/ethnicity. 

conclusions: Results suggest that ACEs are prevalent among women receiving home visiting services.  Although ACEs may vary by race/ethnicity, the deleterious effects of ACEs on maternal health appear to be consistent among racial/ethnic groups.