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Background: Adverse childhood experiences (ACEs) are associated with illicit drug use among pregnant women who are socioeconomically vulnerable. While it is assumed that the impact of ACEs on illicit drug use in pregnancy is reduced among women with higher socioeconomic status (SES), this assumption is not well tested in the literature. The objective of this study was to examine the impact of maternal ACEs on illicit drug use in a community-based sample of pregnant women with middle to high SES., Methods: This study is a secondary analysis of a prospective cohort study that collected data from 1660 women during and after pregnancy in Calgary, Canada between 2008 and 2011 using mailed surveys. Illicit drug use in pregnancy was self-reported by women at 34-36 weeks gestation. An established scale examined maternal ACEs before 18 years. Logistic regression models and 95% confidence intervals tested associations between maternal ACE scores and illicit drug use in pregnancy., Results: Overall, 3.1% of women in this predominantly married, well-educated, middle and upper middle income sample reported illicit drug use in pregnancy. Women with 2-3 ACEs had more than a two-fold increase, and women with 4 or more ACEs had almost a four-fold increase in illicit drug use in pregnancy, relative to women with 0-1 ACEs after adjustment for confounders. Exposure to child abuse was more consistently associated with illicit drug use in pregnancy than exposure to household dysfunction in childhood., Conclusions: Maternal ACEs were common and associated with a moderate increase in the odds of illicit drug use in pregnancy among Canadian women with middle to high SES.

Background: Binge drinking (BD) is a serious risk factor for fetal alcohol spectrum disorders (FASD) and associated with more severe forms of the disorder. Thus, special attention to specific risk factors for BD adjacent to and during pregnancy is warranted., Objectives: (1) To examine the role that maternal adverse childhood experiences (ACEs) may play in BD in the 12 months before pregnancy and during pregnancy in a sample of women with moderate to high socioeconomic status; and (2) to examine the sociodemographic correlates of BD before and during pregnancy within this sample., Participants and Setting: This secondary analysis (N = 1663) was derived from the All Our Families prospective cohort study collected in Alberta, Canada between 2008-2011., Methods: Data were collected using three mailed surveys completed by women during and after pregnancy. An established scale examined maternal ACEs before 18 years. Adjusted logistic regression models tested associations between ACE score and BD before and during pregnancy., Results: Approximately 5 in 10 (48.3 %) and 1 in 10 (10.0 %) women reported ≥1 BD episode before and during pregnancy; respectively. In adjusted models, a woman's ACE score was associated with BD pre-pregnancy in a weak, nonmonotonic fashion; and during pregnancy in a moderate, dose-response fashion. Overall, ACEs resulted in two to three-fold increase in the odds of BD during pregnancy., Conclusions: Maternal ACEs were common in this middle to upper-middle income, well-educated sample and impacted the next generation through BD in pregnancy. These findings combine with others to speak to the public health significance of maternal ACEs on alcohol-related behaviour among expectant mothers across the socioeconomic spectrum, and the need for targeted evidence-based interventions for this population., (Copyright © 2019 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Objective: To examine the association between racial discrimination experienced in childhood on allostatic load (AL) in adulthood, and whether this association differed by cultural continuity among Indigenous adults., Method: Data were collected from Indigenous adults attending university in a small city in western Canada between 2015 and 2017 (N = 105). The frequency of childhood racial discrimination was measured using an item modified from the Experience of Discrimination Scale. AL was measured as a composite of 7 biomarkers assessing neuroendocrine, cardiovascular, metabolic, and immune system function. Cultural continuity was measured using the Vancouver Index Enculturation Scale. Bootstrapped linear regression models examined associations adjusted for confounders, with and without stratification by a dichotomized measure of Indigenous cultural continuity., Results: Most Indigenous adults (72.3%) experienced racial discrimination some or most of the time in childhood. The frequency of child discrimination was significantly associated with AL, explaining 11% of the variance in adult AL score after adjustment for age and income. In the high cultural continuity group, there was no association between child discrimination and adult AL. In the low cultural continuity group, child discrimination was significantly associated with AL, explaining 21% of the variance in adult AL score., Conclusion: Childhood racial discrimination may have a biological toll on adult health through altered activation of the stress response system which could, over time, exacerbate health inequities in this population. High Indigenous cultural continuity served as a resilience factor that buffered the adverse impacts of childhood discrimination on adult AL score., (Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.)