P3.A018: Do maternal adverse childhood experiences (ACEs) affect rates of breastfeeding adherence and neonatal growth as well as mother’s resilience

Background: Adverse childhood experiences (ACEs) have shown to have a negative impact on health outcomes. There is evidence of how negative childhood events adversely affect self-esteem in adulthood. Not only do ACEs have an impact on one's own life, but maternal ACEs have shown to have consequences on infants’ development as well, indicating a negative intergenerational impact.

Methods: Between 2020 and 2023, 120 mother-infant pairs from a New Jersey urban hospital were approached between their 2nd trimester and the 2-month well visit. Mothers completed the ACE Questionnaire and the 7 C’s Tool survey for maternal resilience. Infant developmental milestones were collected from 2-,4-,6- and 12-month well-visits. Chi-square, Mann Whitney U, and independent t-tests were used to examine ACEs, maternal race and resilience, breastfeeding adherence, and infant developmental milestones.

Results: A total of 51% (N=59) of mothers were categorized as having high ACE scores (2+). Higher scores from the 7 C’s Tool survey reflected lower resilience. There was a significant association between maternal ACE scores and higher 7 C’s Tool survey scores, linking lower maternal resilience with higher maternal ACE exposure (p < 0.001). The Pearson correlation coefficient was measured to be 0.318.

There was found to be no significant relationship between ACE scores, race, and breastfeeding, and infant weights and head circumferences. Additionally, there was no significant relationship between resilience scores, race, breastfeeding, and infant weights and head circumferences. Though not statistically significant, non-white mothers had higher median ACEs scores than white mothers. Also, black and Hispanic mothers represented a larger percentage of mothers with high ACEs scores while white mothers represented a lower percentage. Black mothers also represented a higher percentage of mothers categorized as high 7 C’s Tool Survey scores, reflecting lower resilience against adversity.

Conclusion: The data shows evidence for a significant impact of ACEs affecting mothers’ self-perception and self-determined resiliency. Future research should focus on determining the relationship between maternal race, ACEs, and their impact on both maternal and infant health outcomes.