P3.P304: Maternal Adverse Childhood Experiences (ACEs) and Resilience Effect on Birth Weight and Gestational Age

Background: The original Adverse Childhood Experiences (ACE) study demonstrated a dose-response relationship between early exposures to adversities and higher risks of future negative health outcomes, such as ischemic heart disease and cancer. Subsequent studies in the obstetrics population have revealed that ACEs can negatively impact the health of those who did not directly experience the adversity. Thus, intergenerational transmission of ACEs may impact known risk factors for morbidity and mortality among infants, such as small for gestational age (SGA) and preterm birth. Resiliency, which is fostered through positive life experiences, may oppose these negative health consequences.

Methods: ACE questionnaires and the 7 C's Tool resilience questionnaires were administered to 120 consenting mothers between December 2020-August 2023. The ACE questionnaire consists of 10 statements in the categories of abuse, neglect and family dysfunction. The 7C’s Tool is an internally validated questionnaire and modeled by Dr. Ginsburg 7 C's of Positive Development. Chart review was conducted to determine the gestational age and birth weight of each infant and maternal perinatal tobacco use, a known risk factor for SGA. We hypothesized that a greater number of maternal ACEs has an association with infants born SGA (less than the 10th percentile) and preterm (less than 37 weeks gestational age).

Results: The study included 120 neonates, of whom 50% were male and 50% female infants. Of these infants, 76% were born via vaginal delivery, 24 % via cesarean section, 15% were SGA and 14% were born preterm. Per chart review, 10% of mothers smoked tobacco during pregnancy. Maternal total ACE scores did not have a significant effect on the risk of preterm births or birth as SGA (Table 1). Stratifying groups into ACE score of 0, low ACE scores ( < 3) and high ACE scores (≥3) did not correlate with risk of being born preterm or small for GA. Maternal total 7Cs sores were not statistically significant when compared to preterm births or SGA (Table 2).

Conclusion: Though our sample size is limited, there was no significant evidence of a relationship between maternal ACEs scores, resilience, and rates of either SGA or preterm birth.