The Association between Adverse Childhood Experiences and Alcohol Use during Pregnancy in a Representative Sample of Adult Women



      The impact of adverse childhood experiences (ACEs) on adult alcohol consumption is well-established, but little is known about the association with alcohol use during pregnancy.


      Using data from the 2010 Nevada Behavioral Risk Factor Surveillance System, we assessed the relationship between ACEs and alcohol use during pregnancy in a representative sample of 1,987 adult women. An established ACEs scale was used to assess a range of childhood physical, emotional, and sexual abuse and household dysfunction (range, 0–8). Weighted logistic regression was used to assess the relationship between ACE scores and alcohol use during pregnancy after controlling for drinking before pregnancy and other covariates.


      Six percent of participants reported drinking alcohol during pregnancy. After controlling for race/ethnicity, age, employment status, smoking status, and prepregnancy alcohol use, increasing ACEs were positively associated with higher odds of alcohol use during pregnancy (1 ACE: adjusted odds ratio [AOR], 2.92; 95% CI, 1.08–7.87), (2–3 ACEs: AOR, 3.52; 95% CI, 1.46–8.48), and (≥4 ACEs: AOR, 4.79; 95% CI, 2.14–10.72). Prepregnancy drinking was also strongly associated with alcohol use during pregnancy (AOR, 11.95; 95% CI, 5.02–28.43).


      We found evidence of a dose–response relationship between ACEs and alcohol use during pregnancy that remained even after controlling for prepregnancy drinking and other covariates. Screening women of childbearing age as well as pregnant women for ACEs may be an effective way to identify and address many of the emotional, behavioral, and physical sequelae of childhood adversity.
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      David Frankenberger, MPH, is an analyst for the University of California, Davis Medical Center.


      Kristen Clements-Nolle, PhD, MPH, is an associate professor of epidemiology in the department of epidemiology at the University of Nevada, Reno, Nevada.


      Wei Yang, PhD, is a professor of biostatistics and the Director of Nevada Center for Health Statistics and Informatics (NCHSI) at the University of Nevada, Reno.