Maternal History of Adverse Childhood Experiences and Subsequent Infant Paternal Involvement

Abstract

Background and Objective: Adverse childhood experiences (ACEs) are associated with unfavorable pregnancy outcomes. Fathers’ involvement during pregnancy positively impacts maternal behaviors and birth outcomes. Lack of voluntary paternity acknowledgment (PA) at birth implies potential limited paternal involvement. This study explores the association between mothers with a history of ACEs and PA status for their infants. Methods: Using secondary data from the Monroe County Mothers and Babies Health Survey and logistic regression modeling, we assessed the odds of court-mandated paternity affidavit (CM-PA) associated with maternal ACEs. Univariate analyses were conducted first, with additional variables included subsequently. Results: Of the 1,556 mothers with legal paternity established for their infants, 279 (18%) had a CM-PA for their infants, and 1,277 (82%) had a PA established voluntarily (vPA). Mothers of infants with CM-PA were more likely to be Black or Hispanic, had lower income and education, had higher substance use and traumatic stress, and had lower social support. A one-point increase in maternal ACE total score was associated with 14% higher odds of CM-PA (OR = 1.14; 95% CI, 1.03–1.27). Maternal experience of household dysfunction was linked to 83% higher odds of CM-PA (OR = 1.83; 95% CI, 1.23–2.71) while living with a problem drinker or drug user during childhood was associated with 70% higher odds of CM-PA (OR = 1.70; 95% CI, 1.09–2.65). Conclusion and Implications for Translation: This study suggests a potential link between maternal ACEs and CM-PA, implying possible lower father involvement for the infants whose mothers experienced adverse events in childhood. To address this, future research is warranted to confirm this association and explore interventions like prenatal ACE screening in pregnancy, providing psychological support and resources for mothers to promote infant paternal involvement.