Adverse childhood experiences (ACEs) are extremely prevalent in the United States population. Although ACEs occurs in childhood, exposure to them has been associated with adverse future pregnancy outcomes and an increased risk of poorer social determinants of health, which further drive the risk of negative pregnancy outcomes.

Unlike other mental health conditions, such as depression, which is routinely screened for in obstetric care, ACE screening during pregnancy is not consistently performed. As a result, prior trauma often goes unrecognized, missing an opportunity for intervention.

Additionally, the negative health and pregnancy outcomes associated with ACEs are only beginning to be explored. Gaining an accurate physiologic understanding of how ACEs can adversely affect pregnancy and the health of offspring would provide an evidence-based rationale for implementing ACE screening as part of routine obstetric care. It would also advance our scientific understanding of the biological mechanisms behind the transmission of

historical trauma from mother to child and promote the health of future generations by enabling risk stratification of mothers and neonates who may benefit from early interventions.

In the paper, "Placental Cortisol Dysregulation in Mothers with Experiences of Childhood Adversity: Potential Mechanisms and Clinical Implications" Dr Maria Muzik, Dr. Joshua George and Dr. Courtney Townsel, continue to examine the exact biological pathway underlying this intergenerational passage of risk.