Table 3.
Health Outcome Prevalence by ACEs in North Dakota and South Dakota, Pregnancy Risk Assessment Monitoring System, 2016–2018
| Combineda North Dakota and South Dakota |
North Dakota |
South Dakota |
|||||||
|---|---|---|---|---|---|---|---|---|---|
| Outcome | ≥3 ACEsb | 0 ACEs | p-valuec | ≥3 ACEsb | 0 ACEs | p-valuec | ≥3 ACEsb | 0 ACEs | p-valuec |
| Unwanted pregnancy, %d (95% CI) | 10.7 (8.1, 13.2) | 4.2 (2.7, 5.7) | <0.0001 | 10.0 (6.0, 14.0) | 5.5 (2.7, 8.2) | 0.07 | 11.3 (7.9, 14.6) | 3.1 (1.7, 4.5) | <0.0001 |
| PNC | |||||||||
| Adequate PNC by Kotelchuck or Kessner index, %b (95% CIc) |
74.4 (71.4, 77.4) | 83.3 (80.9, 85.7) | <0.0001 | 74.1 (69.1, 79.0) | 80.7 (76.7, 84.8) | 0.045 | 74.7 (71.0, 78.3) | 85.8 (83.1, 88.4) | <0.0001 |
| Pregnancy-related behaviors and experiences | |||||||||
| Physical abuse during pregnancy, %b (95% CIc) | 9.0 (7.0, 11.0) | 0.6 (0.2, 1.0) | <0.0001 | 7.9 (5.1, 10.8) | 0.4 (0.0, 0.8) | <0.0001 | 9.9 (7.2, 12.6) | 0.8 (0.1, 1.4) | <0.0001 |
| Smoking during the last 3 months of pregnancy, %b (95% CIc) | 24.3 (21.2, 27.5) | 3.9 (2.5, 5.3) | <0.0001 | 27.5 (22.1, 33.0) | 5.9 (3.4, 8.5) | <0.0001 | 21.7 (18.0, 25.4) | 1.9 (0.7, 3.1) | <0.0001 |
| Depression during pregnancy, %b (95% CIc) | 29.4 (26.0, 32.7) | 6.0 (4.3, 7.6) | <0.0001 | 28.3 (22.8, 33.8) | 7.1 (4.5, 9.8) | <0.0001 | 30.2 (26.0, 34.4) | 4.8 (2.9, 6.7) | <0.0001 |
| Pregnancy-related conditions | |||||||||
| Gestational diabetes, %b (95% CIc) | 10.3 (8.1, 12.4) | 8.6 (6.9, 10.3) | 0.25 | 9.3 (5.7, 12.9) | 7.4 (4.9, 9.9) | 0.41 | 11.1 (8.4, 13.7) | 9.7 (7.4, 12.1) | 0.47 |
| Gestational hypertension, pre-eclampsia, or eclampsia, %b (95% CIc) | 13.6 (11.1, 16.1) | 9.9 (8.0, 11.9) | 0.02 | 10.8 (7.2, 14.3) | 9.7 (6.7, 12.6) | 0.64 | 16.0 (12.5, 19.4) | 10.2 (7.7, 12. 7) | 0.009 |
| Birth outcomes | |||||||||
| Small for gestational age, %b (95% CIc) | 8.4 (6.3, 10.6) | 7.7 (6.0, 9.5) | 0.62 | 8.8 (5.2, 12.3) | 5.0 (2.7, 7.3) | 0.09 | 8.2 (5.8, 10.8) | 10.4 (7.8, 13.0) | 0.24 |
| Large for gestational age, %b (95% CIc) | 12.4 (9.9, 14.9) | 9.3 (7.4, 11.1) | 0.049 | 14.3 (9.8, 18.7) | 9.0 (6.2, 11.8) | 0.049 | 10.9 (8.1, 13.7) | 9.5 (7.1, 11.9) | 0.47 |
| Low birth weight, %b (95% CIc) | 5.8 (4.2, 7.4) | 5.3 (3.9, 6.7) | 0.65 | 5.3 (2.8, 7.7) | 4.7 (2.6, 6.7) | 0.73 | 6.2 (4.1, 8.3) | 5.9 (4.1, 7.7) | 0.82 |
| Preterm (gestational age <37 weeks), %b (95% CIc) | 9.0 (7.0, 11.0) | 7.7 (6.1, 9.4) | 0.35 | 8.5 (5.4, 11.5) | 7.1 (4.5, 9.6) | 0.49 | 9.4 (6.8, 12.1) | 8.4 (6.2, 10.5) | 0.55 |
| Breastfeeding | |||||||||
| Ever breastfed, %b (95% CIc) | 85.7 (83.1, 88.4) | 92.0 (90.3, 93.8) | 0.0001 | 83.2 (78.7, 87.8) | 91.6 (88.7, 94.4) | 0.003 | 87.8 (84.9, 90.8) | 92.5 (90.4, 94.6) | 0.01 |
Note: Boldface indicates statistical significance (p<0.05).
ACEs questions were not uniform across all the 5 states included in the analysis. States with identical questions were combined (North Dakota, South Dakota; Kansas, Michigan, Rhode Island) to increase study power. In the combined data sets, only variables that were available and identical for all grouped states (North Dakota, South Dakota; Kansas, Michigan, Rhode Island) were included in the ACE score calculation for combined analyses.
ACE count data only calculated for participants with complete data on all ACEs.
p derived from chi-square test.
Weighted percentages. ACE, adverse childhood experience; PNC, prenatal care.