Adverse Childhood Experiences and Complex Post-traumatic Stress in Pregnant Teens: A Pilot Study

Introduction Pregnant teens are seen as a group at risk, yet one area that remains understudied is the impact of trauma on their mental health, maternal fetal attachment and pregnancy-related health behavior. Methods A pilot study of urban pregnant teens receiving home visiting services examined trauma exposure, complex traumatic stress, maternal fetal attachment, and health behaviors of pregnancy. The sample (n = 36) was recruited over a period of 20 months from Nurse-Family Partnership of New York City (NFP-NYC) service sites. The teens interviewed completed scales measuring adverse childhood experiences (ACEs), symptoms of complex posttraumatic stress (TSCC), prenatal attachment (MAAS), and pregnancy health behaviors (HPQ-II). Findings Over one third of participants reported 4 or more ACEs (36%), and scores on the Trauma Symptom Checklist subscales ranged from a low of 11% for anger to 25% for depression, anxiety and post-traumatic stress. Maternal-fetal attachment was strong and pregnancy health behaviors were positive. The number of ACEs was related to traumatic stress symptoms but not to maternal fetal attachment or health behaviors in pregnancy. Conclusions Pregnant teens with trauma histories could benefit from access to trauma-informed mental health services integrated into the obstetrical or home-visiting services they receive.