Maternal Adverse Childhood Experiences, Paternal Involvement, and Infant Health
Alexander Testa1, Dylan B Jackson2
1The Department of Criminology & Criminal Justice, University of Texas at San Antonio, San Antonio, TX.
Insights
Maternal adverse childhood experiences (ACEs) significantly increase risks for low birth weight and preterm birth, but only when fathers lack acknowledgment of paternity (AOP). Interventions are needed for unmarried mothers without paternal involvement.
Area of Science:
- Perinatal health research
- Social determinants of health
- Childhood trauma studies
Background:
- Adverse Childhood Experiences (ACEs) are linked to negative health outcomes.
- Paternal involvement, proxied by acknowledgment of paternity (AOP), may influence infant health.
- The interaction between maternal ACEs and paternal involvement on birth outcomes is not fully understood.
Purpose of the Study:
- To examine the combined effect of maternal ACEs and father's AOP on low birth weight and preterm birth.
- To investigate if father's AOP moderates the association between maternal ACEs and adverse birth outcomes.
Main Methods:
- Utilized data from the 2018 North Dakota and South Dakota Pregnancy Risk Assessment Monitoring System (n=1896).
- Employed logistic regression models to analyze low birth weight and preterm birth.
- Conducted moderation analyses to assess the interaction between maternal ACEs and father's AOP.
Main Results:
- A significant positive interaction was found between accumulating maternal ACEs and lack of AOP for both low birth weight and preterm birth.
- Unmarried mothers without AOP and 4+ maternal ACEs had 3.74x higher odds of low birth weight and 1.74x higher odds of preterm birth compared to those with no ACEs.
- The risk of adverse birth outcomes associated with maternal ACEs was specific to newborns of unmarried women without AOP.
Conclusions:
- Accumulating maternal ACEs significantly elevate risks for adverse infant health outcomes, but this effect is conditional on the absence of father's AOP.
- Findings highlight the critical role of paternal involvement in mitigating the impact of maternal trauma on infant health.
- Future research should focus on interventions to reduce the impact of maternal ACEs, particularly in contexts lacking paternal support.
Objectives:
To assess the interplay between maternal exposure to adverse childhood experiences (ACEs) and father's acknowledgment of paternity (AOP; a proxy for paternal involvement) in the risk of low birth weight (<2500 grams) and preterm birth (<37 weeks) among offspring.
Study Design:
Data come from the 2018 North Dakota and South Dakota Pregnancy Risk Assessment Monitoring System (n = 1896). Logistic regression models were used to assess low birth weight and preterm birth outcomes. Moderation analyses are conducted to assess the interaction between maternal ACEs and father's AOP.
Results:
Moderation analyses demonstrated a positive interaction between an accumulating number of maternal ACEs and being unmarried without AOP for low birth weight and preterm birth. Upon comparing newborns of unmarried women without AOP, those whose mothers were exposed to 4 or more ACEs had a 3.74 times greater probability of low birth weight (0.050 vs 0.187) and a 1.74 times greater probability of preterm birth (0.085 vs 0.148) than those whose mothers reported no ACE exposure.
Conclusions:
Exposure to accumulating ACEs substantially increases the risk of deleterious infant health outcomes, but only for newborns of unmarried women without AOP. Future research should assess the efficacy of interventions that can mitigate the impact of maternal ACEs in the absence of father's AOP.
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