AN INTEGRATIVE REVIEW BETWEEN ADVERSE CHILDHOOD EXPERIENCES AND REPRODUCTIVE TRAUMAS

Abstract

Adverse childhood experiences, or ACEs, are potentially traumatic events that occur in childhood. Women are more likely to experience multiple ACE events, and ACEs are linked to chronic health problems and pregnancy complications. To date, no reviews have been conducted to examine the associations between ACEs and infertility or pregnancy loss. Therefore, the purpose of this integrative review was to explore the relationships between ACEs and the reproductive traumas of infertility and pregnancy loss. An integrative review was conducted using the Whittemore and Knafl framework and Covidence software for data management. Using specific keywords to search PubMed, SocINDEX, PsycINFO, and CINAHL databases, 638 articles were identified. After 113 duplicates were removed, 525 articles were screened for inclusion criteria. Four additional articles were discovered using citation searching, resulting in a total of 20 articles included in the review. A quality appraisal was performed by two team members independently. Relevant data was extracted into a matrix and analyzed using categories for comparisons and emerging themes. Four articles examined the association between infertility and ACEs, and 16 articles examined the relationships between pregnancy loss and ACEs. Preliminary results strongly support an increased risk of pregnancy loss in women with a history of ACE exposure, while three of the 4 studies support an association between infertility and ACEs, especially with the ACE events of emotional abuse, neglect, and sexual abuse. Other themes found among those with ACE and reproductive traumas include disproportionate suffering, physiological weathering, endangerments, and gauging significance, all which may explain the interaction between ACEs and the reproductive traumas of infertility and pregnancy loss. Findings of this integrative review support an association between ACEs and the reproductive traumas of infertility and pregnancy loss, though additional research is needed to further explore the relationships with infertility, the specific type of ACE most likely to be associated with reproductive trauma, the mental health and well-being of the women, and biological changes that may occur because of ACEs could lead to reproductive traumas.