| dc.description.abstract | Background Adverse childhood experiences (ACEs)
have a profound negative impact on health. However, the
strength of the association between ACEs and pregnancy
complications and adverse pregnancy outcomes is not well
quantified or understood.
Objective To conduct a systematic review and meta-
analysis of the association between ACEs and risk
of pregnancy complications and adverse pregnancy
outcomes.
Search strategy A comprehensive search was conducted
using PubMed, Embase, CINAHL, PsycINFO, ClinicalTrials.
gov and Google scholar up to July 2022.
Data collection and analysis Two reviewers
independently conducted the screening and quality
appraisal using a validated tool. Meta-analysis using the
quality-effects model on the reported odds ratio (OR)
was conducted. Heterogeneity and inconsistency were
examined using the I2
statistics.
Results 32 studies from 1508 met a priori inclusion
criteria for systematic review, with 21 included in the
meta-analysis. Pooled analyses showed that exposure
to ACEs increased the risk of pregnancy complications
(OR 1.37, 95% CI 1.20 to 1.57) and adverse pregnancy
outcomes (OR 1.31, 95% CI 1.17 to 1.47). In sub-group
analysis, maternal ACEs were associated with gestational
diabetes mellitus (OR 1.39, 95% CI 1.11 to 1.74), antenatal
depression (OR 1.59, 95% CI 1.15 to 2.20), low offspring
birth weight (OR 1.27, 95% CI 1.02 to 1.47), and preterm
delivery (OR 1.41, 95% CI 1.16 to 1.71).
Conclusion The results suggest that exposure to ACEs
increases the risk of pregnancy complications and adverse
pregnancy outcomes. Preventive strategies, screening and
trauma-informed care need to be examined to improve
maternal and child health. | en_US |
