title: The Association between Adverse Childhood Experiences and Alcohol Use during Pregnancy in a Representative Sample of Adult Women.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Epidemiology, School of Community Health Sciences, University of Nevada, Reno, Reno, Nevada.
authors.forename: David J
authors.initials: DJ
authors.lastname: Frankenberger
authors.affiliation: Department of Epidemiology, School of Community Health Sciences, University of Nevada, Reno, Reno, Nevada. Electronic address: clements@unr.edu.
authors.forename: Kristen
authors.initials: K
authors.lastname: Clements-Nolle
authors.affiliation: Department of Epidemiology, School of Community Health Sciences, University of Nevada, Reno, Reno, Nevada.
authors.forename: Wei
authors.initials: W
authors.lastname: Yang
mesh_terms: D000293:Adolescent; D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology*; D000428:Alcohol Drinking / Q000009:adverse effects*; D040343:Behavioral Risk Factor Surveillance System; D002648:Child; D002649:Child Abuse / Q000523:psychology*; D005006:Ethnicity / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D015438:Health Behavior / Q000208:ethnology*; D006801:Humans; D008016:Life Change Events; D016015:Logistic Models; D008875:Middle Aged; D009505:Nevada / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000523:psychology*; D012307:Risk Factors; D012959:Socioeconomic Factors; D055815:Young Adult