The association between attachment insecurity and negative symptoms in clinical and non-clinical populations: A systematic review and meta-analysis.

Adverse childhood experiences (ACEs) refer to potentially traumatic events that occur during childhood and may have long-lasting impacts on an individual’s health and well-being. The original ACEs study identified various categories of early adversity, including physical, sexual, and emotional abuse; physical and emotional neglect; witnessing domestic violence; and household dysfunction such as parental divorce or separation, or living with a household member who abused substances, had a mental illness, or was incarcerated. More recent research has broadened this concept to include additional stressors such as peer victimization, exposure to community violence, physical disability, parental job loss, and other contextual hardships that affect child development. ACEs are highly prevalent, with an estimated 62.8% of Americans reporting at least one ACE and the burden falls disproportionately on individuals from lower socioeconomic backgrounds, where exposure to multiple forms of adversity is more common. ACEs are also specifically prevalent among teenage mothers. A cohort study in California, US, shows that over 40% of pregnant teenagers have experienced four or more ACEs. Adverse birth outcomes are critical public health issues worldwide, as they encompass a wide range of complications that affect both maternal and infant health. These outcomes include preterm birth (PTB), low birth weight (LBW), gestational diabetes, hypertensive disorders of pregnancy, stillbirth, and other complications that can contribute substantially to perinatal morbidity and mortality. The consequences extend beyond the perinatal period, as children born preterm or with LBW have increased risks of developmental delays, chronic disease, and early mortality. In low- and middle-income countries (LMICs), the burden of these outcomes is particularly high. PTB, defined as gestational age < 37 weeks at birth, remains at a high rate in LMICs, around 9% to 13%. For LBW (birth weight < 2500 grams, LBW), the estimated rate from six LMICs is 14%. As of 2019, about 21 million teenage pregnancies occurred in LMICs, resulting in a large number of teenage mothers that were under the age of 19. Teenage mothers have a significantly higher risk of adverse birth outcomes compared to their adult counterparts. The morbidity and mortality of infants of teenage mothers due to adverse outcomes are also higher. Given the overwhelming health burden of adverse birth outcomes in teenage mothers from LMICs, identifying the risk factors for effective prevention in this susceptible group is warranted.