Prenatal substance exposure, adverse childhood experiences and diagnosed mental and behavioral disorders
The results of the study suggest that adverse childhood experiences may have a greater effect on mental and behavioral disorders of adolescence and adults with prenatal substance exposure than has been previously reported.
Both prenatalsubstance exposure (alcohol/illicit drugs) and recurrent traumatic experiences, especially in early life during rapid brain development, can cause enduring brain dysfunction. However, the combined effect of these factors has got little attention especially regarding research on alcohol exposure.
This is one of the first longitudinal studies investigating the effect of prenatal substance exposure and adverse childhood experiences (ACEs) on mental and behavioral disorders in exposed adolescents and young adults. The data consisted of 615 exposed (to alcohol and/or drugs) youth aged 15-24 years and 1787 matched unexposed controls. Data from hospital medical records and nine registers were merged for the analysis. Descriptive analysis methods and Cox regression were used.
The results showed that the prevalence of mental and behavioral disorders was twice as high (55%) among exposed compared with controls (26%). The highest levels of mental and behavioral disorders and ACEs were found among exposed with at least one out-of-home care (OHC) episode. The difference in the risk of mental and behavioral disorders between exposed and controls diminished after controlling for the effect of ACEs. Low birth weight, maternal risk factors, and OHC were the strongest predictors of mental and behavioral disorders in both groups.
The results suggest that prenatal substance exposure alone does not explain poorer mental health among exposed youth. Risk factors accumulate, and low birth weight and ACEs are strongly associated with increased risk of mental and behavioral disorders.
Original article:
Koponen, A. M., Nissinen, N-M., Gissler, M., Autti-Rämö, I., Sarkola, T. & Kahila, H. (2020). Prenatal substance exposure, adverse childhood experiences and diagnosed mental and behavioral disorders - a longitudinal register-based matched cohort study in Finland. SSM Population Health, 11, 100625.