Published August 2019 | Journal of Pediatrics

When a child experiences potentially traumatic events, the negative effects on wellbeing can last into adulthood. If they grow up to become a parent, can these adverse childhood experiences (ACEs) affect how they support healthcare services for their children?

For mothers in particular, the answer may be yes, according to a study led by researchers in the Mayerson Center for Safe and Healthy Children.

“The practice of pediatrics is multi-generational,” says Robert Allan Shapiro, MD, corresponding author and director of the Mayerson Center. “Identifying tools that help us better understand our patients’ parents could help us improve the health of our patients.”

In this study, researchers explored parental exposure to ACEs and patients’ healthcare use by two years of age. The cohort included 454 patients at a large suburban pediatric primary care practice whose mother, father, or both completed an ACE survey.

Using multivariable negative binomial regression, the research team modeled the association between self-reported parental ACEs and the number of missed well-child visits, sick visits, and delayed or missed immunizations.

For each additional maternal ACE, the team found a significant 12 percent increase in the rate of missed well-child visits. For these patients, ACE exposure of mothers was associated with worse adherence to preventive healthcare visits early in life.

In partnership with Beech Acres Parenting Center, the research team has developed a program called Parent Connext aimed at preventing and reducing the impact of ACEs on children. The program empowers pediatricians to screen for parenting and family psychosocial concerns. On-site parenting specialists are also available to provide individualized coaching to parents related to these concerns.

Ongoing research seeks to examine the intervention’s effect on healthcare utilization.

Adjusted IRR for Missed Well-Child Visits by Parental ACE Exposure