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Am J Perinatol 2025; 42(09): 1168-1178
DOI: 10.1055/a-2464-3665
Original Article

The Association between Perinatal Complications and Adverse Childhood Experiences: Findings from a Nationwide Online Survey

Yousuke Imanishi 
1   Division of Public Health, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Suita City, Osaka, Japan
,
Ichiro Wada
2   Department of Interdisciplinary Studies, Faculty of International Liberal Arts, Dokkyo University, Saitama, Japan
,
Takahiro Tabuchi
3   Department of Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
4   Division of Epidemiology, School of Public Health, Tohoku University Graduate School of Medicine, Miyagi, Japan
› Author Affiliations
Funding This study was supported by the Japan Society for the Promotion of Science KAKENHI (grant number: JP 21H04856 and 22K18566) and the Japan Science and Technology Agency (grant number: JPMJSC21U6); Intramural Fund of the National Institute for Environmental Studies; Innovative Research Program on Suicide Countermeasures (grant number: R3-2-2); Ministry of Health Labor and Welfare of Health Labor Sciences Research Grant (grant number: 23GC1019); and Ready for COVID-19 Relief Fund (grant number: 5th period 2nd term 001). The findings and conclusions of this study are the unique responsibilities of the authors and do not represent their views on research funding.
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Abstract

Objective

This study aimed to evaluate the association between maternal adverse childhood experiences (ACEs) levels and the risk of perinatal complications.

Study Design

This is a retrospective cohort study of 5,693 mother–child pairs born between 2019 and 2021, who completed questionnaires on maternal ACE scores and perinatal complications such as preterm birth, low birth weight infants, pregnancy-induced hypertension (PIH), gestational diabetes mellitus (GDM), and premature rupture of membrane (PROM). Odds ratios (OR) and 95% confidence intervals (CI) were calculated using logistic regression according to the three ACE score groups after adjusting for confounding factors such as maternal age, child's sex, household income, and maternal education.

Results

Maternal ACEs have a significant positive correlation with preterm birth (OR: 1.42, 95% CI: 1.09–1.86, p for trend = 0.009), PIH (OR: 1.55, 95% CI: 1.17–2.07, p for trend = 0.002), and PROM (OR: 1.42, 95% CI: 1.09–1.84, p for trend = 0.01). These associations remained unchanged when stratified according to smoking, alcohol consumption, and obesity.

Conclusion

Maternal ACEs were associated with the risk of perinatal complications such as preterm birth, PIH, and PROM.

Key Points

  • Maternal ACEs are linked to higher risks of preterm birth, PIH, and PROM.

  • Parental divorce, emotional abuse, and neglect were the most common ACEs among Japanese mothers.

  • Mothers with ACEs score ≥ 2 had a higher risk of perinatal complications.

Keywords

adverse childhood experiences - preterm - pregnancy-induced hypertension - premature rupture of membrane - prospective study

Ethics Approval and Consent to Participate

We used data from two rounds of the JACSIS, which complied with the ethical standards of the relevant national and institutional committees on human experimentation and the 1975 Declaration of Helsinki and its 2008 revision. Ethical approval was obtained from the Research Ethics Committee of the Research Ethics Committee of the Osaka International Cancer Institute (approved June 19, 2020; approval no. 20084). Written informed consent to participate was not directly obtained but inferred by the completion of the questionnaire/participant in the interview.


Author's Contributions

Y.I. and I.W. were involved in study design and data interpretation. Y.I. analyzed the data. I.W. and T.T. revised the manuscript critically. All authors approved the final manuscript.


Availability of Data and Materials

Owing to the presence of personally identifiable or potentially sensitive information, the data used in the present study were not deposited in a public repository. The Research Ethics Committee of the Osaka International Cancer Institute has restricted data sharing in compliance with the Japanese ethical guidelines. All questions on data use were directed to Takahiro Tabuchi at tabuchitak@gmail.com. Additional information regarding data availability was obtained from the JACSIS Web site ( https://jacsis-study.jp/howtouse/ ).




Publication History

Received: 08 September 2024

Accepted: 07 November 2024

Article published online:
13 December 2024

© 2024. Thieme. All rights reserved.

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