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Maternal Adverse Childhood Experiences, Family Strengths, and Chronic Stress in Children

Condon, Eileen M.; Holland, Margaret L.; Slade, Arietta; Redeker, Nancy S.; Mayes, Linda C.; Sadler, Lois S.

doi: 10.1097/NNR.0000000000000349

Background Researchers have demonstrated that maternal adverse childhood experiences (ACEs), such as abuse and neglect, are associated with prenatal risk factors and poor infant development. However, associations with child physiologic and health outcomes, including biomarkers of chronic or “toxic” stress, have not yet been explored.

Objectives The purpose of this study was to examine the associations among past maternal experiences, current maternal posttraumatic stress disorder (PTSD) symptoms, and children's indicators of exposure to chronic stress in a multiethnic sample of mothers and children at early school age (4 to 9 years).

Methods This cross-sectional study included maternal–child dyads (N = 54) recruited from urban community health centers in New Haven, Connecticut. Mothers reported history of ACEs, family strengths, and current PTSD symptoms. Child measures included biomarkers and health and developmental outcomes associated with chronic stress. Correlational and regression analyses were conducted.

Results Childhood trauma in mothers was associated with higher systolic blood pressure percentile (ρ = .29, p = .03) and behavioral problems (ρ = .47, p = .001) in children, while maternal history of family strengths was associated with lower salivary interleukin (IL)-1β (ρ = −.27, p = .055), salivary IL-6 (ρ = −.27, p = .054), and body mass index z-scores (ρ = −.29, p = .03) in children. Maternal PTSD symptoms were associated with more child behavioral problems (ρ = .57, p < .001) and higher odds of asthma history (ρ = .30, p = .03).

Discussion Results indicate that past maternal experiences may have important influences on a child's health and affect his or her risk for experiencing toxic stress.

Eileen M. Condon, PhD, APRN, FNP-BC, is Postdoctoral Fellow, Yale School of Nursing, Orange, Connecticut.

Margaret L. Holland, PhD, MPH, MS, is Associate Research Scientist, Yale School of Nursing, Orange, Connecticut.

Arietta Slade, PhD, is Clinical Professor, Yale Child Study Center, New Haven, Connecticut.

Nancy S. Redeker, PhD, RN, FAHA, FAAN, is Professor, Yale School of Nursing and Yale School of Medicine, New Haven, Connecticut.

Linda C. Mayes, MD, is Professor and Chair, Yale Child Study Center, New Haven, Connecticut.

Lois S. Sadler, PhD, RN, FAAN, Professor, Yale School of Nursing and Yale Child Study Center, New Haven, Connecticut.

Accepted for publication September 11, 2018.

The authors would like to thank Andrea Miller for her assistance with recruitment and data collection and the Yale School of Nursing Biobehavioral Laboratory for providing necessary resources.

The authors also thank the families who participated in this study for contributing their time and expertise.

The research reported in this publication was supported by the National Institute of Nursing Research of the National Institutes of Health under award number F31NR016385. This work was also supported by the NAPNAP Foundation, the Connecticut Nurses Foundation, the Jonas Nurse Leaders Scholars Program, and the Alpha Nu chapter of Sigma Theta Tau International.

The Yale University institutional review board approved all research reported in this manuscript.

The authors have no conflicts of interest to report.

Corresponding author: Eileen M. Condon, PhD, APRN, FNP-BC, Yale School of Nursing, 400 West Campus Drive, Orange, CT 06477 (e-mail:

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