Direct association between maternal adverse childhood experiences and offspring age at initiation of regular alcohol use

AIMS: To estimate the extent to which maternal adverse childhood experiences (ACEs) predict offspring age at initiation of regular alcohol use, directly and indirectly via offspring ACEs. METHODS: This was a retrospective cohort study using data collected from a nationally representative sample of mothers enrolled in the National Longitudinal Survey of Youth 1979 and their offspring who were enrolled in a separate cohort. Maternal and offspring ACEs were retrospectively self-reported. Age of initiation of regular alcohol use was collected via offspring report. We fit causal mediation models to determine associations between maternal ACEs and offspring age at initiation of regular alcohol use, including unmediated and mediated effects. Models were adjusted for generation-specific confounders. Offspring who reported living with a problem drinker or alcoholic were removed from the sample in a sensitivity analysis. RESULTS: Among 4277 offspring born to 2326 mothers, the majority were born to mothers who reported no ACEs (58.7%), who had at least a high school education (76.6%), and were married (62.4%). For every one-unit increase in maternal ACEs, offspring engaged in regular alcohol use 0.17 years earlier, of which approximately 28.9% of the total effect β = -0.17 (95% CI: -0.25, -0.08) is mediated by offspring ACEs. Findings were confirmed in sensitivity analyses. CONCLUSION: Maternal ACEs were associated with earlier offspring regular alcohol use in a dose-dependent manner, independent of offspring ACEs, and other known intergenerational determinants of alcohol use. Maternal ACE screening and early service provision may provide a novel opportunity to delay alcohol use.