Prolonged Exposure to Childhood Adversity and Birth Outcomes in a Bi-Generational Longitudinal Cohort Study

A higher number of exposures to different adverse childhood experiences (ACEs) has been associated with worse birth outcomes; however, the duration of ACE exposure could also negatively impact pregnancy outcomes. We sought to use a bi-generational longitudinal cohort survey to test if duration of exposure to specific types of childhood adversity exhibited a graded association with adverse birth outcomes.

The Bureau of Labor Statistics' National Longitudinal Surveys of Youth 1979 cohort was used to create bi-generational cohorts capturing the number and duration of ACE events (reported by the oldest cohort and experienced by the middle cohort) and linking these with birth outcomes (low birth weight, preterm birth, route of delivery, and infant length of stay) documented in the youngest cohort. ACEs examined were maternal incarceration, divorce/separation, maternal binge drinking, and poverty.

Demographic, birth outcome, and ACE exposures were determined from 1693 cases. Neither the count of ACEs nor the duration of exposure to ACEs was a statistically significant predictor of examined birth outcomes, except for greater ACE numbers and prolonged infant length of stay.

No association was identified between worsened birth outcomes and cumulative number or duration of ACE exposures, contradicting prior studies. This discrepancy may be explained by the mediating role of stressors encountered in adulthood, interactions between ACE exposure and adult-onset conditions, missing data on paternal ACE exposure, or differences in recall and reporting bias when collecting interview data from participants versus directly from the grandparent generation.