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J Pediatr. 2017 Aug;187:282-289.e1. doi: 10.1016/j.jpeds.2017.04.052. Epub 2017 May 23.

Maternal Adverse Childhood Experience and Infant Health: Biomedical and Psychosocial Risks as Intermediary Mechanisms.

Author information

1
Department of Psychology, University of Calgary, Calgary, Canada; Alberta Children's Hospital Research Institute, Calgary, Canada. Electronic address: sheri.madigan@ucalgary.ca.
2
Department of Applied Psychology and Human Development, University of Toronto, Toronto, Canada.
3
Département des fondements et pratiques en éducation, Université Laval, Quebec City, Canada.
4
Department of Pediatrics, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada; Division of Pediatric Medicine, Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, Toronto, Canada; Faculty of Medicine, Departments of Paediatrics and Nutritional Sciences, Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Canada.
5
Department of Applied Psychology and Human Development, University of Toronto, Toronto, Canada. Electronic address: jenny.jenkins@utoronto.ca.

Abstract

OBJECTIVE:

To assess the mechanisms accounting for the transfer of risk from one generation to the next, especially as they relate to maternal adverse childhood experiences and infant physical and emotional health outcomes.

STUDY DESIGN:

Participants were 501 community mother-infant dyads recruited shortly after the birth and followed up at 18 months. Mothers retrospectively reported on their adverse childhood experiences. The main outcome measures were parent-reported infant physical health and emotional problems. Potential mechanisms of intergenerational transmission included cumulative biomedical risk (eg, prenatal and perinatal complications) and postnatal psychosocial risk (eg, maternal depression, single parenthood, marital conflict).

RESULTS:

Four or more adverse childhood experiences were related to a 2- and 5-fold increased risk of experiencing any biomedical or psychosocial risk, respectively. There was a linear association between number of adverse childhood experiences and extent of biomedical and psychosocial risk. Path analysis revealed that the association between maternal adverse childhood experiences and infant physical health operated specifically through cumulative biomedical risk, while the relationship between adverse childhood experiences and infant emotional health operated specifically through cumulative psychosocial risk. This pattern was not explained by maternal childhood disadvantage or current neighborhood poverty.

CONCLUSIONS:

Maternal adverse childhood experiences confer vulnerability to prenatal, perinatal, and postnatal psychosocial health. The association between adverse childhood experiences and offspring physical and emotional health operates through discrete intermediary mechanisms.

KEYWORDS:

cumulative risk; mother-child health; psychosocial risk; social determinants of health

PMID:
28549634
DOI:
10.1016/j.jpeds.2017.04.052
[Indexed for MEDLINE]

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