• Nicole Racine, Sheila McDonald, Kathleen Chaput, Suzanne Tough, and Sheri Madigan.
• Department of Psychology, Faculty of Arts, University of Calgary, Alberta Children's Hospital Research Institute, 2500 University Dr. NW, Calgary, AB T2N 1N4, Canada. Electronic address: Nicole.racine2@ucalgary.ca.
• Prev Med. 2020 Dec 1; 141: 106303.

AbstractSubstance use in pregnancy, including alcohol use, drug use, or smoking, is associated with poor health outcomes for both the mother and her unborn child. Building on previous research that has examined the cumulative impact of Adverse Childhood Experiences (ACEs) on maternal binge drinking and alcohol use in pregnancy, the current study sought to examine the association between maternal ACEs and substance use in pregnancy more broadly, including alcohol use, binge drinking, smoking, and drug use. Furthermore, we also examined how different adversity subtypes, including sexual abuse, family violence (physical abuse, emotional abuse), and household dysfunction, differentially predict maternal substance use behavior. A sample of 1994 women were recruited between 2008 and 2011 from a community-based pregnancy cohort in Calgary, Canada. Self-reported information on exposure to ACEs prior to the age of 18 years and maternal substance usewere collected. Examining ACE subtypes, medium effects were observed for the role of household-dysfunction on binge drinking, drug use, and smoking in pregnancy, while only small effects were observed for family violence on binge drinking, drug use, and smoking. There were no significant effects for sexual abuse after controlling for covariates. A dose-response association between the number of ACEs and substance use in pregnancy was also demonstrated. Increased support prior to, and in pregnancy, particularly for women with a history of childhood adversity, is needed to reduce substance use behaviors in pregnancy.Copyright © 2020 Elsevier Inc. All rights reserved.

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