Increased Pregnancy Complications Among Mothers With Adverse Childhood Experiences: Findings From a Cross‐Sectional Study

BACKGROUND: Adverse Childhood Experiences (ACEs) are potentially traumatic events and family challenges that occur during childhood (0-17 years). Extensive research has linked ACEs to adverse effects throughout life. However, recent studies suggest that ACEs may also have intergenerational consequences, influencing pregnancy complications and perinatal outcomes. OBJECTIVE: In this study, we aim to explore the association between maternal ACEs and perinatal outcomes in the Dutch preventive healthcare context. PARTICIPANTS AND SETTING: In this retrospective cross-sectional observational study, survey data from 793 mothers with a singleton child under 2 years of age were analyzed. METHODS: We used logistic and linear regression models to analyze the association between self-reported ACE-10 scores, pregnancy complications, and birth outcomes. Adjusted models included maternal birth year, country of birth, and benevolent childhood experiences. RESULTS: ACEs were common: 46.5% of mothers had experienced 1-3 ACEs and 18.2% reported ≥ 4 ACEs. Mothers with ≥ 4 ACEs had 1.70 times higher odds of pregnancy complications (aOR = 1.70, 95% CI: 1.05-2.74, p = 0.031). Linear regression with continuous ACEs showed a similar trend (aOR = 1.09, 95% CI: 1.00-1.18, p = 0.069). No associations were found for prematurity, small for gestational age, NICU admission, birth weight, or gestational age. CONCLUSIONS: Maternal ACEs were associated with pregnancy complications (gestational hypertension, gestational diabetes, preeclampsia or premature rupture of membranes) but not directly with birth outcomes (prematurity or low birth weight). These findings highlight the importance of early psychosocial risk detection. Strengthening preventive care systems, such as the Dutch system, may help mitigate intergenerational adversity, even without formal ACE screening.