Adverse childhood experiences and marijuana use during pregnancy: Findings from the North Dakota and South Dakota PRAMS, 2017–2019. (1st January 2022) - Testa, Alexander
Abstract: Background: Emerging research suggests that adverse childhood experiences (ACEs) may be a risk factor for prenatal marijuana use. This study is the first to use a representative sample from state surveillance systems to assess the connection between accumulating ACEs and marijuana use during pregnancy. Methods: Data are from the North Dakota and South Dakota Pregnancy Risk Assessment Monitoring System (PRAMS) from years 2017–2019 ( N = 5399). The bivariate association between number of ACEs and marijuana use during pregnancy is assessed using a chi-square test. The multivariable association is assessed using linear probability modeling. Results: Only 0.9% of women with zero ACEs reported marijuana use during pregnancy, compared to 11.7% of women with four or more ACEs. Findings from linear probability models showed that mothers reporting two ACEs ( b =0.023, 95% CI =0.003, .043), three ACEs ( b =0.042, 95% CI =0.014, .069), and four or more ACEs ( b =0.053, 95% CI =0.035, .071) are more likely to report marijuana use during pregnancy relative to those with zero ACEs, net of demographic and socioeconomic control variables. Conclusions: Accumulating maternal ACEs —especially four or more— is associated with increased likelihood of using marijuana during pregnancy. These findings demonstrate the early life trauma is a key social determinant of health over the life course and highlights how ACEs can contribute to intergenerational harm via the worsening of health behaviors during pregnancy. Highlights: Adverse childhood experiences (ACEs) carry repercussions for health behaviors Limited research assesses the link between ACEs and marijuana use during pregnancy ACE exposure is associated with increased risk for marijuana use during pregnancy Maternal ACEs poses risk for adverse prenatal health behaviors