Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ASCO Annual Meeting 2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

2024 ASCO Annual Meeting

Keep up to date with all the top stories and latest evidence with our hub page, including official congress videos and expert takeaways.
ADVANCED SEARCH
Log in
Top
BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2021

Open Access 01-12-2021 | Child Abuse | Research article

Adverse childhood experiences are associated with illicit drug use among pregnant women with middle to high socioeconomic status: findings from the All Our Families Cohort

Authors: Cheryl L. Currie, Suzanne C. Tough

Published in: BMC Pregnancy and Childbirth | Issue 1/2021

Login to get access

Abstract

Background

Adverse childhood experiences (ACEs) are associated with illicit drug use among pregnant women who are socioeconomically vulnerable. While it is assumed that the impact of ACEs on illicit drug use in pregnancy is reduced among women with higher socioeconomic status (SES), this assumption is not well tested in the literature. The objective of this study was to examine the impact of maternal ACEs on illicit drug use in a community-based sample of pregnant women with middle to high SES.

Methods

This study is a secondary analysis of a prospective cohort study that collected data from 1660 women during and after pregnancy in Calgary, Canada between 2008 and 2011 using mailed surveys. Illicit drug use in pregnancy was self-reported by women at 34–36 weeks gestation. An established scale examined maternal ACEs before 18 years. Logistic regression models and 95% confidence intervals tested associations between maternal ACE scores and illicit drug use in pregnancy.

Results

Overall, 3.1% of women in this predominantly married, well-educated, middle and upper middle income sample reported illicit drug use in pregnancy. Women with 2–3 ACEs had more than a two-fold increase, and women with 4 or more ACEs had almost a four-fold increase in illicit drug use in pregnancy, relative to women with 0–1 ACEs after adjustment for confounders. Exposure to child abuse was more consistently associated with illicit drug use in pregnancy than exposure to household dysfunction in childhood.

Conclusions

Maternal ACEs were common and associated with a moderate increase in the odds of illicit drug use in pregnancy among Canadian women with middle to high SES.
Literature
1.
2.
Cook JL, Green CR, de la Ronde S, Dell CA, Graves L, Ordean A, et al. Epidemiology and effects of substance use in pregnancy. J Obstet Gynaecol Canada. 2017;39(10):906–15.CrossRef
3.
4.
Kotelchuck M, Cheng ER, Belanoff C, Cabral HJ, Babakhanlou-Chase H, Derrington TM, et al. The prevalence and impact of substance use disorder and treatment on maternal obstetric experiences and birth outcomes among singleton deliveries in Massachusetts. Matern Child Health J. 2017;21(4):893–902.PubMedPubMedCentralCrossRef
5.
Chiandetti A, Hernandez G, Mercadal-Hally M, Alvarez A, Andreu-Fernandez V, Navarro-Tapia E, et al. Prevalence of prenatal exposure to substances of abuse: questionnaire versus biomarkers. Reprod Health. 2017;14(1):137.PubMedPubMedCentralCrossRef
6.
Ko JY, Patrick SW, Tong VT, Patel R, Lind JN, Barfield WD. Incidence of neonatal abstinence syndrome - 28 States, 1999–2013. Morb Mortal Wkly Rep. 2016;65(31):799–802.CrossRef
7.
Lester BM, Tronick EZ, LaGasse L, Seifer R, Bauer CR, Shankaran S, et al. The maternal lifestyle study: effects of substance exposure during pregnancy on neurodevelopmental outcome in 1-month-old infants. Pediatrics. 2002;110(6):1182–92.PubMedCrossRef
8.
Administration SA and MHS. Results from the 2012 National Survey on Drug Use and Health: Detailed tables. 2013.
9.
10.
Mcmillin GA, Wood KE, Strathmann FG, Krasowski M. Patterns of drugs and drug metabolites observed in meconium. Ther Drug Monit. 2015;37(5):568–80.PubMedCrossRef
11.
Roncero C, Valriberas-Herrero I, Mezzatesta-Gava M, Villegas JL, Aguilar L, Grau-López L. Cannabis use during pregnancy and its relationship with fetal developmental outcomes and psychiatric disorders: a systematic review. Reprod Health. 2020;17(1):25.PubMedPubMedCentralCrossRef
12.
Warner TD, Roussos-Ross D, Behnke M. It’s not your mother’s marijuana: effects on maternal-fetal health and the developing child. Clin Perinatol. 2014;41(4):877–94.PubMedPubMedCentralCrossRef
13.
dos Santos JF, de Melo Bastos Cavalcante C, Barbosa FT, Gitaí DLG, Duzzioni M, Tilelli CQ, et al. Maternal, fetal and neonatal consequences associated with the use of crack cocaine during the gestational period: a systematic review and meta-analysis. Arch Gynecol Obstet. 2018;298(3):487–503.PubMedCrossRef
14.
Gouin K, Murphy K, Shah PS. Effects of cocaine use during pregnancy on low birthweight and preterm birth: Systematic review and metaanalyses. Am J Obstet Gynecol. 2011;204(4):340.e1–340.e12.CrossRef
15.
Kalaitzopoulos D-R, Chatzistergiou K, Amylidi A-L, Kokkinidis DG, Goulis DG. Effect of methamphetamine hydrochloride on pregnancy outcome. J Addict Med. 2018;12(3):220–6.PubMedCrossRef
16.
Lind JN, Interrante JD, Ailes EC, Gilbosa S, Khan S, Frey M, et al. Maternal use of opioids during pregnancy and congenital malformations: a systematic review. Am Acad Pediatr. 2017;139(6):e20164131.
17.
Gunn JKL, Rosales CB, Center KE, Nuñez A, Gibson SJ, Christ C, et al. Prenatal exposure to cannabis and maternal and child health outcomes: a systematic review and meta-analysis. BMJ Open. 2016;6(4):e009986.PubMedPubMedCentralCrossRef
18.
19.
Porath A, Beirness D, Diplock J, Kalant H. Clearing the smoke on cannabis: maternal cannabis use during pregnancy – an update. Ottawa: Canadian Centre on Substance Abuse; 2015.
20.
Richardson GA, Goldschmidt L, Larkby C, Day NL. Effects of prenatal cocaine exposure on child behavior and growth at 10 years of age. Neurotoxicol Teratol. 2013;40:1–8.PubMedCrossRef
21.
Diaz SD, Smith LM, Lagasse LL, Derauf C, Newman E, Shah R, et al. Effects of prenatal methamphetamine exposure on behavioral and cognitive findings at 7.5 years of age. J Pediatr. 2014;164(6):1333–8.PubMedPubMedCentralCrossRef
22.
Conradt E, Flannery T, Aschner JL, Annett RD, Croen LA, Duarte CS, Friedman AM, Guille C, Hedderson MM, Hofheimer J, Jones MR, Ladd-Acosta C, McGrath M, Moreland A, et al. Prenatal opioid exposure: neurodevelopmental consequences and future research priorities. Pediatrics. 2019;144(3):e20190128.
23.
Yeoh SL, Eastwood J, Wright IM, Morton R, Melhuish E, Ward M, et al. Cognitive and motor outcomes of children with prenatal opioid exposure: a systematic review and meta-analysis. JAMA Netw Open. 2019;2(7):197025.CrossRef
24.
Gonçalves H, Soares ALG, Santos APG dos, Ribeiro CG, Bierhals IO, Vieira LS, et al. Adverse childhood experiences and consumption of alcohol, tobacco and illicit drugs among adolescents of a Brazilian birth cohort. Cad Saude Publica. 2016;32(10):e00085815.PubMedCrossRef
25.
Varner MW, Silver RM, Hogue CJR, Willinger M, Parker CB, Thorsten VR, et al. Association between stillbirth and illicit drug use and smoking during pregnancy. Obstet Gynecol. 2014;123(1):113–25.PubMedPubMedCentralCrossRef
26.
Tupper KW, McCrae K, Garber I, Lysyshyn M, Wood E. Initial results of a drug checking pilot program to detect fentanyl adulteration in a Canadian setting. Drug Alcohol Depend. 2018;190:242–5.PubMedCrossRef
27.
Hans SL. Demographic and psychosocial characteristics of substance-abusing pregnant women. Clin Perinatol. 1999;26:55–74.PubMedCrossRef
28.
Wendell AD. Overview and epidemiology of substance abuse in pregnancy. Clin Obstet Gynecol. 2013;56:91–6.PubMedCrossRef
29.
Hughes K, Bellis MA, Hardcastle KA, Sethi D, Butchart A, Mikton C, et al. The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis. Lancet Public Heal. 2017;2(8):e356–66.CrossRef
30.
Dube SR, Felitti VJ, Dong M, Giles WH, Anda RF. The impact of adverse childhood experiences on health problems: evidence from four birth cohorts dating back to 1900. Prev Med (Baltim). 2003;37(3):268–77.CrossRef
31.
Petersen AC, Joseph J, Feit M. New directions in child abuse and neglect research. Washington: National Academies Press; 2014.
32.
Afifi TO, Enns MW, Cox BJ, Asmundson GJG, Stein MB, Sareen J. Population attributable fractions of psychiatric disorders and suicide ideation and attempts associated with adverse childhood experiences. Am J Public Health. 2008;98(5):946–52.PubMedPubMedCentralCrossRef
33.
McDonald SW, Madigan S, Racine N, Benzies K, Tomfohr L, Tough S. Maternal adverse childhood experiences, mental health, and child behaviour at age 3: the all our families community cohort study. Prev Med (Baltim). 2019;118:286–94.CrossRef
34.
Hunt TKA, Slack KS, Berger LM. Adverse childhood experiences and behavioral problems in middle childhood. Child Abuse Negl. 2017;67:391–402.PubMedCrossRef
35.
Dube SR, Anda RF, Felitti VJ, Edwards VJ, Williamson DF. Exposure to abuse, neglect, and household dysfunction among adults who witnessed intimate partner violence as children: implications for health and social services. Violence Vict. 2002;17(1):3–17.PubMedCrossRef
36.
Raposo SM, Mackenzie CS, Henriksen CA, Afifi TO. Time does not heal all wounds: older adults who experienced childhood adversities have higher odds of mood, anxiety, and personality disorders. Am J Geriatr Psychiatry. 2014;22(11):1241–50.PubMedCrossRef
37.
Currie CL. Animal cruelty by children exposed to domestic violence. Int J Child Abus Negl. 2006;30(4):425–35.CrossRef
38.
Chung EK, Nurmohamed L, Mathew L, Elo IT, Coyne JC, Culhane JF. Risky health behaviors among mothers-to-be: the impact of adverse childhood experiences. Acad Pediatr. 2010;10(4):245–51.PubMedPubMedCentralCrossRef
39.
Leeners B, Rath W, Block E, Görres G, Tschudin S. Risk factors for unfavorable pregnancy outcome in women with adverse childhood experiences. J Perinat Med. 2014;42(2):171–8.PubMedCrossRef
40.
Young-Wolff KC, Alabaster A, McCaw B, Stoller N, Watson C, Sterling S, et al. Adverse childhood experiences and mental and behavioral health conditions during pregnancy: the role of resilience. J Women’s Heal. 2019;28(4):452–61.CrossRef
41.
Tough SC, McDonald SW, Collisson BA, Graham SA, Kehler H, Kingston D, et al. Cohort profile: the all our babies pregnancy cohort (AOB). Int J Epidemiol. 2017;46(5):1389–1390k.PubMedCrossRef
42.
Gracie SK, Lyon AW, Kehler HL, Pennell CE, Dolan SM, McNeil DA, et al. All our babies cohort study: recruitment of a cohort to predict women at risk of preterm birth through the examination of gene expression profiles and the environment. BMC Pregnancy Childbirth. 2010;10(1):87.PubMedPubMedCentralCrossRef
43.
Tough S, Benzies K, Collisson B, Graham S, McDonald S, Slater D, et al. All Our Babies/Families (AOB/F). V15 ed. Tough S, Benzies K, Collisson B, Graham S, McDonald S, Slater D, et al., editors. UAL Dataverse; Available from: https://​doi.​org/​10.​7939/​DVN/​10793
44.
McDonald SW, Lyon AW, Benzies KM, McNeil DA, Lye SJ, Dolan SM, et al. The All Our Babies pregnancy cohort: design, methods, and participant characteristics. BMC Pregnancy Childbirth. 2013;13 Suppl 1(Suppl 1):S2.PubMedCrossRef
45.
Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: the adverse childhood experiences (ACE) study. Am J Prev Med. 1998;14(4):245–58.PubMedCrossRef
46.
Hetherington E, Racine N, Madigan S, McDonald S, Tough S. Relative contribution of maternal adverse childhood experiences to understanding children’s externalizing and internalizing behaviours at age 5: findings from the All Our Families Cohort. C Open. 2020;8(2):E352–9.
47.
48.
Rohrer JM. Thinking clearly about correlations and causation: graphical causal models for observational data. Adv Methods Pract Psychol Sci. 2018;1(1):27–42.CrossRef
49.
Statistics Canada. 2011 National Household Survey. Ottawa: Statistics Canada catalogue no. 99-014-X2011047; 2013.
50.
Merrick MT, Ford DC, Ports KA, Guinn AS. Prevalence of adverse childhood experiences from the 2011-2014 behavioral risk factor surveillance system in 23 states. JAMA Pediatr. 2018;172(11):1038–44.PubMedPubMedCentralCrossRef
51.
52.
Duffy KA, McLaughlin KA, Green PA. Early life adversity and health-risk behaviors: proposed psychological and neural mechanisms. Ann N Y Acad Sci. 2018;1428(1):151–69.PubMedPubMedCentralCrossRef
53.
McLaughlin KA, DeCross SN, Jovanovic T, Tottenham N. Mechanisms linking childhood adversity with psychopathology: learning as an intervention target. Behav Res Ther. 2019;118:101–9.PubMedPubMedCentralCrossRef
54.
Dennison MJ, Rosen ML, Sambrook KA, Jenness JL, Sheridan MA, McLaughlin KA. Differential associations of distinct forms of childhood adversity with neurobehavioral measures of reward processing: a developmental pathway to depression. Child Dev. 2019;90(1):e96–113.PubMedCrossRef
55.
Brenhouse H, Lukkes J, Andersen S. Early life adversity alters the developmental profiles of addiction-related prefrontal cortex circuitry. Brain Sci. 2013;3(4):143–58.PubMedPubMedCentralCrossRef
56.
Audrain-McGovern J, Rodriguez D, Leventhal AM, Cuevas J, Rodgers K, Sass J. Where is the pleasure in that? Low hedonic capacity predicts smoking onset and escalation. Nicotine Tob Res. 2012;14(10):1187–96.PubMedPubMedCentralCrossRef
57.
Herringa RJ, Birn RM, Ruttle PL, Burghy CA, Stodola DE, Davidson RJ, et al. Childhood maltreatment is associated with altered fear circuitry and increased internalizing symptoms by late adolescence. Proc Natl Acad Sci. 2013;110(47):19119–24.PubMedCrossRef
58.
Hall JL. Van Teijlingen ER. A qualitative study of an integrated maternity, drugs and social care service for drug-using women. BMC Pregnancy Childbirth. 2006;6(1):19.PubMedPubMedCentralCrossRef
59.
Hardt J, Sidor A, Bracko M, Egle UT. Reliability of retrospective assessments of childhood experiences in Germany. J Nerv Ment Dis. 2006;194(9):676–83.PubMedCrossRef
60.
Reuben A, Moffitt TE, Caspi A, Belsky DW, Harrington H, Schroeder F, et al. Lest we forget: comparing retrospective and prospective assessments of adverse childhood experiences in the prediction of adult health. J Child Psychol Psychiatry. 2016;57(10):1103–12.PubMedPubMedCentralCrossRef
61.
62.
Krumpal I. Determinants of social desirability bias in sensitive surveys: a literature review. Quality Quantity. 2013;47:2025–47.CrossRef
63.
64.
Webb P, Bain C, Page A. Essential Epidemiology. 4th ed. Cambridge: Cambridge University Press; 2020.
65.
Statistics Canada. Focus on geography series, 2016 census. Ottawa: Vol. Statistics; 2017.
Metadata
Title
Adverse childhood experiences are associated with illicit drug use among pregnant women with middle to high socioeconomic status: findings from the All Our Families Cohort
Authors
Cheryl L. Currie
Suzanne C. Tough
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2021
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-021-03591-1

Other articles of this Issue 1/2021

BMC Pregnancy and Childbirth 1/2021 Go to the issue

Research article

Physical activity and sedentary time during pregnancy and associations with maternal and fetal health outcomes: an epidemiological study

Research article

Implementation of a fetal ultrasound telemedicine service: women’s views and family costs

Research article

Waterbirth: a national retrospective cohort study of factors associated with its use among women in England

Research article

The impact of cesarean delivery on infant DNA methylation

Case report

When a vesicular placenta meets a live fetus: case report of twin pregnancy with a partial hydatidiform mole

Case report

Ralstonia mannitolilytica sepsis after elective cesarean delivery: a case report