433 - Incidence of Adverse Childhood Experiences in a Neonatal Intensive Care Unit
Saturday, April 29, 2023
3:30 PM – 6:00 PM ET
Poster Number: 433 Publication Number: 433.219
Kaitlyn Judkins, University of Utah School of Medicine, Salt Lake City, UT, United States; Carrie Torr, University of Utah School of Medicine, Salt Lake City, UT, United States
Neonatal-Perinatal Medicine Fellow University of Utah School of Medicine Salt Lake City, Utah, United States
Background: Studies have shown that children of mothers with adverse childhood experiences (ACEs) have increased odds of adverse outcomes. However, an infant’s ACEs are not routinely documented in the neonatal intensive care unit (NICU), and it is unknown whether a specific exposure or number of ACEs a neonate is born with is associated with adverse outcomes.
Objective: Determine the incidence of ACEs documented for infants admitted to a NICU and assess for an association between neonatal ACEs and adverse outcomes.
Design/Methods: An IRB approved, retrospective chart review was performed at the University of Utah Level III NICU. Infants born between January 2022 to July 2022 were included. Neonatal and maternal charts were reviewed for five ACEs including: parental intimate partner violence, parental mental illness, parental incarceration, parental separation, and parental substance use. Demographic and outcomes data were also obtained and compared using Chi square test.
Results: Data collection is complete for 100/203 infants. Median gestational age was 33.9 weeks (range 23.9-39.6 weeks) with median birthweight of 2160 grams (range 390-4320g). One or more ACEs were documented in 66% (n=66) of infants and 3 or more ACEs in 9% of infants. Incidence of ACES documented include: intimate partner violence (4%), parental mental illness (56%), parental incarceration (7%), parental separation (17%) and substance use (11%). Notably, 54% of infants had maternal mental illness documented, but only 2% had paternal mental illness documented. Nearly all reported ACEs were maternal in origin as paternal history was rarely recorded. There was no difference in length of stay, preterm birth, or death before discharge or one year of age between those with at least 3 reported ACES and those with none.
Conclusion(s): While outcomes did not differ in neonates with or without ACEs, the true incidence of ACEs in the NICU remains unknown as the majority of paternal data is not documented in the infant’s chart. There is an increased need to screen and document ACEs in infants admitted to the NICU to better understand how to provide trauma-informed care and improve neonatal outcomes. We next plan to evaluate methods to improve identification and documentation of parental social and medical histories in a neonate’s chart and follow short and long-term outcomes.
