Perinatal interventions to prevent Adverse Childhood Experiences (ACEs): A scoping review

Area of Science:

• Public Health
• Perinatal Health
• Child Development

Background:

• Preventing Adverse Childhood Experiences (ACEs) is a public health priority.
• The perinatal period offers a critical window for effective ACE prevention interventions.
• Interventions can optimize child development and break intergenerational cycles of adversity.

Purpose of the Study:

• Identify high-quality randomized controlled trials (RCTs) of perinatal ACE prevention interventions.
• Examine interventions from a dyadic perspective, assessing outcomes for both mother and child.
• Analyze interventions based on the public health prevention continuum and Life Course Intervention Research (LCIR) characteristics to determine effectiveness.

Main Methods:

• Conducted a scoping review of articles from January 2000 to November 2023 using PsychInfo and PubMed.
• Included RCTs targeting ACEs or risks, with mother and child outcomes initiated during pregnancy.
• Analyzed interventions using prevention continuum and LCIR frameworks; used t-tests to assess LCIR characteristics' association with outcomes.

Main Results:

• Analyzed 57 articles representing 53 unique perinatal interventions.
• 74% of interventions reported positive impacts, with 56% benefiting both mother and child.
• Co-parenting programs, home visiting, and integrative health (baby massage/yoga) showed strongest evidence; secondary prevention was common.

Conclusions:

• While few studies explicitly defined ACEs, perinatal interventions positively impacted individual ACE risks.
• Incorporating life course characteristics into comprehensive perinatal interventions shows promise for future ACE prevention.
• Bundling evidence-based components enhances the potential of perinatal interventions for ACE prevention.