Associations between Adverse Childhood Experiences and Sexual Risk among Postpartum Women. 2021

Jordan L Thomas, and Jessica B Lewis, and Jeannette R Ickovics, and Shayna D Cunningham
Department of Psychology, University of California Los Angeles (UCLA), Los Angeles, CA 90095, USA.

Epidemiological evidence suggests that exposure to adverse childhood experiences (ACEs) is associated with sexual risk, especially during adolescence, and with maternal and child health outcomes for women of reproductive age. However, no work has examined how ACE exposure relates to sexual risk for women during the postpartum period. In a convenience sample of 460 postpartum women, we used linear and logistic regression to investigate associations between ACE exposure (measured using the Adverse Childhood Experiences Scale) and five sexual risk outcomes of importance to maternal health: contraceptive use, efficacy of contraceptive method elected, condom use, rapid repeat pregnancy, and incidence of sexually transmitted infections (STIs). On average, women in the sample were 25.55 years of age (standard deviation = 5.56); most identified as Black (60.4%), White (18%), or Latina (14.8%). Approximately 40% were exposed to adversity prior to age 18, with the modal number of experiences among those exposed as 1. Women exposed to ACEs were significantly less likely to use contraception; more likely to elect less-efficacious contraceptive methods; and used condoms less frequently (p = 0.041 to 0.008). ACE exposure was not associated with rapid repeat pregnancy or STI acquisition, p > 0.10. Screening for ACEs during pregnancy may be informative to target interventions to reduce risky sexual behavior during the postpartum period.

UI MeSH Term Description Entries
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000076783 Adverse Childhood Experiences Deleterious experiences in first 18 years of life. Adolescent Trauma,Childhood Trauma,Early Life Stress,Early-Life Stress,Traumatic Childhood Experiences,Adolescent Traumas,Adverse Childhood Experience,Childhood Experience, Adverse,Childhood Experience, Traumatic,Childhood Experiences, Adverse,Childhood Experiences, Traumatic,Childhood Traumas,Early Life Stresses,Early-Life Stresses,Experience, Traumatic Childhood,Experiences, Traumatic Childhood,Life Stress, Early,Life Stresses, Early,Stress, Early Life,Stress, Early-Life,Stresses, Early Life,Stresses, Early-Life,Trauma, Adolescent,Trauma, Childhood,Traumas, Adolescent,Traumas, Childhood,Traumatic Childhood Experience
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D012725 Sexual Behavior Sexual activities of humans. Anal Sex,Oral Sex,Sexual Activity,Sexual Orientation,Premarital Sex Behavior,Sex Behavior,Sex Orientation,Sexual Activities,Activities, Sexual,Activity, Sexual,Behavior, Premarital Sex,Behavior, Sex,Behavior, Sexual,Orientation, Sexual,Sex, Anal,Sex, Oral
D012749 Sexually Transmitted Diseases Diseases due to or propagated by sexual contact. Venereal Diseases,STDs,STIs,Sexually Transmitted Infections,Disease, Sexually Transmitted,Disease, Venereal,Diseases, Sexually Transmitted,Diseases, Venereal,Infection, Sexually Transmitted,Infections, Sexually Transmitted,STI,Sexually Transmitted Disease,Sexually Transmitted Infection,Transmitted Infection, Sexually,Transmitted Infections, Sexually,Venereal Disease
D017280 Condoms A sheath that is worn over the penis during sexual behavior in order to prevent pregnancy or spread of sexually transmitted disease. Condom,Condom Manufacture,Manufacture, Condom
D049590 Postpartum Period In females, the period that is shortly after giving birth (PARTURITION). Puerperium,Postpartum,Postpartum Women,Period, Postpartum,Women, Postpartum

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