Childhood hardships are associated with many indicators of maternal/infant health and well-being

Background:  Adversity in childhood has been linked with poor health in adulthood, but little research has examined impacts during pregnancy or postpartum.

Methods:  Using data from 13,354 US-born women in California’s 2011-2013 Maternal Infant Health Assessment, a statewide-representative survey of postpartum women, we examined relationships between several childhood hardships (parental separation/divorce, incarceration, or alcohol/drug problem;  foster care; trouble meeting basic needs; hunger; housing insecurity) and 31 indicators of health or well-being (including  maternal/infant health-related behaviors, receipt of medical care, maternal health status, birth outcomes, socioeconomic resources and stressors during pregnancy).  We examined the prevalence of each indicator in relation to the number of childhood hardships, unadjusted and adjusted for potential confounders.

Results: Half of US-born women experienced at least 1 childhood hardship and 28% experienced 2 or more. After adjustment, experiencing 2 or more childhood hardships was significantly associated with poorer outcomes in 20 of 31 indicators.  For 17 of the indicators, there was an apparent gradient effect, with magnitude of risk increasing as the number of childhood hardships increased.  Adjusted prevalence ratios varied, but in 14 indicators there was a doubling (or more) of risk for women with 4 or more childhood hardships compared to none.

Conclusions: The pervasive and strong relationship of California women’s childhood hardships to so many adverse health-related indicators around the time of pregnancy is striking.  These associations, particularly given the dose-response patterns observed for many outcomes, add to a growing literature suggesting that policies to improve health in adulthood may require improving conditions during childhood.