Maternal History of Adverse Childhood Experiences and Ambulatory Blood Pressure in Pregnancy
Margaret H. Bublitz, Laura Georgina Ward, Meera Simoes, Laura R. Stroud, Myriam Salameh, Ghada Bourjeily
Abstract
OBJECTIVE: This study aimed to study the association between maternal history of childhood adversity and blood pressure in pregnancy. METHODS: A total of 127 pregnant women completed measures of adverse childhood experiences (ACE) and prenatal stress between June 2015 and April 2019. At 11 weeks' gestation (range, 6-17 weeks), we measured 24-hour ambulatory blood pressure. All women were considered to be at risk for pregnancy complications due to elevated body mass index and self-reporting snoring in pregnancy. RESULTS: Women were, on average, 30 years old (range, 19-40 years), and average (standard deviation) body mass index in this sample was 34 (7) kg/m (range, 27-55 kg/m). Higher ACE scores were associated with higher nighttime blood pressure (systolic blood pressure: β = 0.23, p = .013; diastolic blood pressure: β = 0.22, p = .028). There were no significant associations between the ACE score and daytime blood pressure. Women with four or more ACEs were more likely to display nocturnal blood pressure nondipping (odds ratio = 3.97, 95% confidence interval = 1.38-11.40). Associations between ACE and nocturnal blood pressure remained significant after adjusting for symptoms of prenatal stress. CONCLUSIONS: Results indicate that experiences of childhood adversity are associated with elevated nocturnal blood pressure and loss of a typical decline in blood pressure between day and night.