Maternal Adverse and Protective Childhood Experiences and Prenatal Smoking

Prenatal smoking is associated with adverse pregnancy and birth outcomes as well as health problems in early childhood. Recent research determined that maternal adverse childhood experiences (ACEs) increase the odds of smoking during pregnancy. We consider the role of protective and compensatory childhood experiences (PACEs) in an effort to examine the extent to which positive childhood experiences are protective factors for maternal smoking behaviors. Between 2015-2018, 309 pregnant women in Oklahoma recruited from high-risk prenatal clinics, childbirth education classes, and social media were surveyed about their childhood experiences and smoking behaviors during pregnancy. Ordinal regression analysis was used to examine the association between ACEs, PACEs, and prenatal smoking frequency. Similar to prior studies, we found women with more ACEs reported smoking more frequently during pregnancy. Women with more PACEs reported significantly less frequent prenatal smoking. With both ACEs and PACEs in the model, however, ACEs was no longer a significant predictor of maternal prenatal smoking. Our findings suggest that protective and compensatory childhood experiences may be more salient for prenatal smoking behaviors than adverse childhood experiences. Identifying protective factors for pregnancy health risk behaviors such as smoking can offer a target for intervention and prevention.