Adverse childhood experiences, migraine, and adverse pregnancy outcomes among teenage mothers

OBJECTIVE: The objective of this study was to assess the individual and joint association of adverse childhood experiences (ACEs) and migraine with adverse pregnancy outcomes. PURPOSE: Teenage pregnancy is prevalent, particularly in low- and middle-income countries. Teenage mothers sustain higher risk of adverse birth outcomes compared to their adult counterparts. ACEs and migraine are prevalent among teenage mothers and may contribute to adverse pregnancy outcomes. METHODS: Cross-sectional data were obtained from 819 Peruvian teenage mothers (aged 14 to 18 years) enrolled in the Teen Pregnancy Outcomes, Maternal, and Infant Study from November 2016 to September 2018 in Lima, Peru. Mothers having 4+ ACEs were considered as having high ACEs. Migraine was classified based on ICHD-3 criteria. Adverse pregnancy outcomes included preterm birth (PTB) and low birth weight (LBW). RESULTS: High ACEs were associated with greater odds of PTB (adjusted odds ratio [aOR] = 2.25, 95% confidence interval [CI]: 1.25, 3.95) and LBW (aOR = 2.64, 95% CI: 1.46, 4.67). Participants with migraine also had higher odds of PTB (aOR = 2.15, 95% CI: 1.20, 3.77). When examined jointly, those with only migraine (aOR = 2.79, 95% CI: 1.41, 5.52) or only high ACEs (aOR = 2.94, 95% CI: 1.48, 5.83) showed increased odds of PTB, whereas the combined exposure to both was weaker (aOR = 2.69, 95% CI: 1.04, 6.95), suggestive of a possible negative interaction, although inferences from this are limited by our relatively small sample size as reflected by the wide 95% CI. Similar patterns were observed for LBW. CONCLUSIONS: High ACEs and migraine were each independently associated with increased odds of PTB and LBW, but joint exposure did not increase the odds beyond the individual contributions. The suggestion of a possible negative interaction between high ACEs and migraine warrants further investigation to confirm.