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Adverse childhood experiences, resilience, and substance use during early pregnancy

Kelly C Young-Wolff1, Mariah S Wood2, Sara R Adams2

  • 1Division of Research, Kaiser Permanente Northern California, Pleasanton, CA, USA; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA.

Preventive Medicine
|August 15, 2025
PubMed

Insights

Adverse childhood experiences (ACEs) are linked to increased prenatal substance use. Routine screening for ACEs can identify at-risk pregnancies for early intervention and improved outcomes.

Area of Science:

  • Public Health
  • Reproductive Health
  • Psychology

Background:

  • Adverse childhood experiences (ACEs) are prevalent and associated with long-term health issues.
  • The link between ACEs and prenatal substance use is not well understood.
  • Resilience may play a role in mitigating the effects of ACEs.

Purpose of the Study:

  • To investigate the association between ACEs and prenatal substance use.
  • To examine the moderating role of resilience in this relationship.

Main Methods:

  • Retrospective cohort study of 44,284 pregnancies.
  • Utilized universal screening for ACEs, resilience, and substance use.
  • Employed multivariable regression models to analyze associations.

Main Results:

  • Higher ACEs correlated with lower resilience, younger age, and increased neighborhood deprivation.
  • ACEs were significantly associated with higher prevalence of prenatal alcohol, cannabis, nicotine, opioid, and stimulant use.
  • Low resilience independently predicted increased prenatal substance use.

Conclusions:

  • Routine ACEs screening can identify pregnant individuals at risk for substance use.
  • Early identification facilitates timely access to resources.
  • This approach may lead to better maternal and child health outcomes.
Abstract

Keywords:
ACEsPregnancyResilienceSubstance use

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