Adverse childhood experiences are associated with illicit drug use among pregnant women with middle to high socioeconomic status: findings from the All Our Families Cohort.
BACKGROUND
Adverse childhood experiences (ACEs) are associated with illicit drug use among pregnant women who are socioeconomically vulnerable. While it is assumed that the impact of ACEs on illicit drug use in pregnancy is reduced among women with higher socioeconomic status (SES), this assumption is not well tested in the literature. The objective of this study was to examine the impact of maternal ACEs on illicit drug use in a community-based sample of pregnant women with middle to high SES.


METHODS
This study is a secondary analysis of a prospective cohort study that collected data from 1660 women during and after pregnancy in Calgary, Canada between 2008 and 2011 using mailed surveys. Illicit drug use in pregnancy was self-reported by women at 34-36 weeks gestation. An established scale examined maternal ACEs before 18 years. Logistic regression models and 95% confidence intervals tested associations between maternal ACE scores and illicit drug use in pregnancy.


RESULTS
Overall, 3.1% of women in this predominantly married, well-educated, middle and upper middle income sample reported illicit drug use in pregnancy. Women with 2-3 ACEs had more than a two-fold increase, and women with 4 or more ACEs had almost a four-fold increase in illicit drug use in pregnancy, relative to women with 0-1 ACEs after adjustment for confounders. Exposure to child abuse was more consistently associated with illicit drug use in pregnancy than exposure to household dysfunction in childhood.


CONCLUSIONS
Maternal ACEs were common and associated with a moderate increase in the odds of illicit drug use in pregnancy among Canadian women with middle to high SES.
['Currie|Cheryl L|CL|http://orcid.org/0000-0001-5366-0641', 'Tough|Suzanne C|SC|']
D000293:Adolescent D000328:Adult D000076783:Adverse Childhood Experiences D002170:Canada D005260:Female D006801:Humans D013287:Illicit Drugs D008875:Middle Aged D011247:Pregnancy D037841:Pregnant Women D011446:Prospective Studies D012923:Social Class D019966:Substance-Related Disorders D055815:Young Adult
Adverse childhood experiences Illicit drug use All our families Pregnancy