Patterns of adverse childhood experiences and associations with prenatal substance use and poor infant outcomes in a multi-country cohort of mothers: a latent class analysis

Abstract

AbstractBackgroundThis paper enumerates and characterizes latent classes of adverse childhood experiences and investigates how they relate to prenatal substance use (i.e., smoking, alcohol, and other drugs) and poor infant outcomes (i.e., infant prematurity and low birthweight) across eight low- and middle-income countries (LMICs).MethodsA total of 1189 mother-infant dyads from the Evidence for Better Lives Study cohort were recruited. Latent class analysis using the Bolck, Croon, and Hagenaars (BCH) 3-step method with auxiliary multilevel logistic regressions was performed.ResultsThree high-risk classes and one low-risk class emerged: (1)highly maltreated(7%,n = 89), (2) emotionally and physically abused with intra-familial violence exposure(13%,n = 152), (3),emotionally abused(40%,n = 474), and (4)low household dysfunction and abuse(40%,n = 474). Pairwise comparisons between classes indicate higher probabilities of prenatal drug use in thehighlymaltreated andemotionally abusedclasses compared with thelow household dysfunction and abuseclass. Additionally, theemotionally and physically abused with intra-familial violence exposureclass had higher probability of low birthweight than the three remaining classes.ConclusionOur results highlight the multifaceted nature of ACEs and underline the potential importance of exposure to childhood adversities on behaviors and outcomes in the perinatal period. This can inform the design of antenatal support to better address these challenges.