Dataset Information

Adverse Childhood Experiences are Associated with Miscarriage in Adulthood: The GROWH Study.

ABSTRACT:

Objectives

To investigate whether adverse childhood experiences are associated with miscarriage.

Methods

The Gulf Resilience on Women's Health Consortium recruited from clinics and community organizations in Southern Louisiana, 2011-2016. Data from 1511 reproductive-aged women with at least one pregnancy were analyzed. Adverse childhood experiences including abuse, neglect, and family dysfunction, as a child (< age 12), and as an adolescent (12-17), were assessed. Outcome measures were self-reported miscarriage at first pregnancy and at any pregnancy, analyzed with logistic regression with adjustment for maternal age at pregnancy, race, BMI, education, marital and smoking status.

Results

Women reporting four or more adversities as a child and as a teen had higher odds of experiencing miscarriage at first pregnancy (AOR_child 1.71, 95% CI 1.00-2.90; AOR_teen 1.73, 95% CI 1.05-2.87) and miscarriage at any pregnancy (AOR_child 1.74, 95% CI 1.16-2.62; OR_teen 1.65, 95% CI 1.10-2.45) compared to those with no adverse childhood experiences. Similar patterns of association were seen for other ACE sub-categories.

Conclusions

Childhood adversities were associated with miscarriage. Further research is needed on the pathways which created this association, including psychological, behavioral, and physiological mechanisms and factors which can mitigate the effects of these outcomes.

SUBMITTER: Kerkar S

PROVIDER: S-EPMC7965336 | biostudies-literature | 2021 Mar

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Adverse Childhood Experiences are Associated with Miscarriage in Adulthood: The GROWH Study.

Kerkar Shweta S Shankar Arti A Boynton-Jarrett Renee R Harville Emily W EW

Maternal and child health journal 20210103 3

<h4>Objectives</h4>To investigate whether adverse childhood experiences are associated with miscarriage.<h4>Methods</h4>The Gulf Resilience on Women's Health Consortium recruited from clinics and community organizations in Southern Louisiana, 2011-2016. Data from 1511 reproductive-aged women with at least one pregnancy were analyzed. Adverse childhood experiences including abuse, neglect, and family dysfunction, as a child (< age 12), and as an adolescent (12-17), were assessed. Outcome measures ...[more]

PMID: 33389588

Similar Datasets

Project description:Study questionIs there an association between adverse childhood experiences (ACE) and the risk of miscarriage in the general population?Summary answerSpecific ACE as well as the summary ACE score were associated with an increased risk of single and recurrent miscarriages.What is known alreadyThere is scarce evidence on the association between ACE and miscarriage risk.Study design, size, durationWe conducted a retrospective national cohort study. The sample consisted of 2795 women aged 55-89 years from the English Longitudinal Study of Ageing (ELSA).Participants/materials, setting, methodsOur study was population-based and included women who participated in the ELSA Life History Interview in 2007. We estimated multinomial logistic regression models of the associations of the summary ACE score and eight individual ACE variables (pertaining to physical and sexual abuse, family dysfunction and experiences of living in residential care or with foster parents) with self-reported miscarriage (0, 1, ≥2 miscarriages).Main results and the role of chanceFive hundred and fifty-three women (19.8% of our sample) had experienced at least one miscarriage in their lifetime. Compared with women with no ACE, women with ≥3 ACE were two times more likely to experience a single miscarriage in their lifetime (relative risk ratio 2.00, 95% CI 1.25-3.22) and more than three times more likely to experience recurrent miscarriages (≥2 miscarriages) (relative risk ratio 3.10, 95% CI 1.63, 5.89) after adjustment for birth cohort, age at menarche and childhood socioeconomic position. Childhood experiences of physical and sexual abuse were individually associated with increased risk of miscarriage.Limitations, reasons for cautionGiven the magnitude of the observed associations, their biological plausibility, temporal order and consistency with evidence suggesting a positive association between ACE and adverse reproductive outcomes, it is unlikely that our findings are spurious. Nevertheless, the observed associations should not be interpreted as causal as our study was observational and potentially susceptible to bias arising from unaccounted confounders. Non-response and ensuing selection bias may have also biased our findings. Retrospectively measured ACE are known to be susceptible to underreporting. Our study may have misclassified cases of ACE and possibly underestimated the magnitude of the association between ACE and the risk of miscarriage.Wider implications of the findingsOur study highlights experiences of psychosocial adversity in childhood as a potential risk factor for single and recurrent miscarriages. Our findings contribute to a better understanding of the role of childhood trauma in miscarriage and add an important life course dimension to the study of miscarriage.Study funding/competing interest(s)ELSA is currently funded by the National Institute on Aging in USA (R01AG017644) and a consortium of UK government departments coordinated by the National Institute for Health Research. The funders had no role in the study design, data collection and analysis, decision to publish or preparation of the article. The authors have no actual or potential competing financial interests to disclose.

Project description:BackgroundAdverse childhood experiences (ACEs) can have lasting effects on adult health and survival. In this study, we aimed to examine how the cumulative number and clustering patterns of ACEs were related to premature mortality.MethodsParticipants (N=46 129; 45% White, 48% Black; 49·5% females) were offspring (born in 1959-1966) of participants enrolled in the Collaborative Perinatal Project (CPP). We conducted latent class analysis to examine the clustering patterns of ACEs assessed between children's birth and age seven. We also calculated the cumulative ACE scores of 13 individual ACEs. Cox regression models were used to examine the associations of ACE clusters and scores with risk of premature mortality from adolescence to mid-adulthood.FindingsAt the start of the follow-up for mortality in 1979, participants were 12-20 years old (Mean=15·99 years), and within the 38-year follow-up through 2016, 3 344 deaths were observed among the 46 129 CPP offspring. Five latent classes of ACEs were identified. Compared to children with Low Adversity (48% of the sample), children in Family Instability (9%, HR=1·28, 95%CI 1·07-1·53), Poverty & Crowded Housing (21%, HR=1·41, 95%CI 1·24-1·62), and Poverty & Parental Separation (19%, HR=1·50, 95%CI 1·33-1·68) classes had higher hazards of premature mortality. In addition, children with 2 (HR=1·27, 95%CI 1·14-1·41), 3 (HR=1·29, 95%CI 1·15-1·45), and 4+ (HR=1·45, 95%CI 1·30-1·61) ACEs had higher hazards of mortality than those with no ACE. The clusters of Poverty & Crowded Housing (HR=1·28, 95%CI 1·10-1·49) and Poverty & Parental Separation (HR=1·23, 95%CI 1·02-1·48) remained associated with higher risk of premature mortality, beyond the cumulative risk of higher number of ACEs (HR=1·05, 95%CI 1·01-1·08).InterpretationAbout half of the CPP cohort experienced early life adversities that clustered into four distinct patterns, which were associated with different risk of premature mortality. It is important to deepen our understanding of how specific clusters of childhood adversities affect health and premature mortality to better inform approaches to prevention and interventions.

Project description:IntroductionRecent reviews have found substantial links between a toxic childhood environment including child abuse and severe household dysfunction and adult cardiovascular disease (CVD). Collectively referred to as adverse childhood experiences (ACEs), this toxic environment is prevalent among children, with recent Canadian estimates of child abuse at 27%-32%, and severe household dysfunction at 49%. Based on these prevalence rates, the potential effect of ACEs on CVD is more significant than previously thought. Yet, how ACEs amplify the risk for later CVD remains unclear. Lifestyle risk factors only partially account for this connection, instead directing attention to the interaction between psychosocial factors and physiological mechanisms such as inflammation. The Niagara Longitudinal Heart Study (NLHS) examines how ACEs influence cardiovascular health (CVH) from childhood to early adulthood. Integrating the stress process and biological embedding models, this study examines how psychosocial and physiological factors in addition to lifestyle factors explain the relationship between ACEs and CVH.MethodsThis follow-up study combines three baseline studies from 2007 to 2012 that collected CVH measures including child blood pressure, heart rate, left ventricular structure and function, arterial stiffness indices and baroreflex sensitivity on 564 children. Baseline data also include anthropometric, biological, lifestyle, behavioural, and psychosocial measures that varied across primary studies. Now over 18 years of age, we will recruit and retest as many participants from the baseline studies as possible collecting data on ACEs, CVH, anthropometric, lifestyle and psychosocial measures as well as blood, saliva and hair for physiological biostress markers.Ethics and disseminationEthics approval has been received for the NLHS follow-up. Written consent to participate in the follow-up study is obtained from each participant. Results testing all proposed hypotheses will be submitted for publication in peer-reviewed journals.

Dataset Information

Adverse Childhood Experiences are Associated with Miscarriage in Adulthood: The GROWH Study.

Objectives

Methods

Results

Conclusions

Publications

Adverse Childhood Experiences are Associated with Miscarriage in Adulthood: The GROWH Study.

Similar Datasets

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