Empirically Derived Patterns of Adverse Childhood Experiences and Associations With Prenatal Social Networks

Objective: Research has established a strong link between social networks and health outcomes, but less work has examined how adverse childhood experiences (ACEs) impact prenatal social networks. This study explored classes of ACEs in association with family, friend, and partner social support network size, controlling for income and past-year intimate partner violence (IPV) exposure. Method: Participants included 238 pregnant women (Mage = 26.86, SD = 5.88; 54.4% Black) recruited from community organizations serving families in the Midwest and Midsouth, United States. Women were recruited from community organizations, flyers posted in local businesses, and study staff recruitment at local agencies and events. Women self-reported on ACEs, IPV, monthly income, and their social networks. Results: A latent class analysis yielded a 3-class solution: a high exposure class (38.7%), a sexual abuse/household dysfunction (SA/HD) class (20.2%), and a low exposure class (41.2%). Women in the high exposure class reported smaller family networks compared to the SA/HD and low exposure classes, but larger friend networks than the low exposure class. Women in the high exposure class reported more partner connections than the SA/HD class. Women in the high exposure class reported more frequent IPV than the low exposure class. Conclusions: Patterns of ACEs were differentially associated with women's social support network size. Findings suggest that pregnant women exposed to high levels of ACEs may be more likely to rely on friends or partners for support, instead of family. Prenatal group-based services could provide opportunities for pregnant women to process various adverse experiences and bolster social connections.