Skip to main content
SMFM 2026 Pregnancy Meeting Main banner
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Presentation Icons
Additional registration fee required
Additional registration fee required
Faculty have requested this content not be shared outside of the session
Faculty have requested this content not be shared outside of the session
CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
Recording available 2/16-5/2
Recording available 2/16-5/2
AIUM Credit
AIUM Credit
Foundation Awardee
Foundation Awardee
Poster Icons
Abstract Award
Abstract Award
Foundation Awardee
Foundation Awardee

Poster Session 4

Category: Perinatal Mental Health

Poster Session 4

(1182) Adverse Childhood Experiences and Postpartum Healthcare Utilization Following Cesarean Birth: A Pilot Prospective Cohort Study

Thursday, February 12, 2026
3:30 PM - 5:00 PM  
Foundation Awardee
Objective:
Adverse childhood experiences (ACEs) affect over 60% of U.S. adults and are linked to chronic disease, opioid use, and increased healthcare utilization in non-pregnant populations. Yet, their impact during the postpartum period—a time of heightened vulnerability—is poorly understood. We evaluated the association between ACEs and postpartum emergency department (ED) visits or hospital readmissions within six weeks of cesarean birth.

Study Design:
We analyzed data from a prospective cohort study of patients aged 18–55, literate in English or Spanish, who delivered a singleton liveborn infant via low-transverse cesarean under neuraxial anesthesia at a single tertiary care center (2023–2024). ACE scores (0–10) were collected using a validated tool and categorized by trauma subtype (abuse, neglect, household dysfunction). ACEs were modeled using two cutoffs: >1 ACE versus none, and >4 ACEs versus < 4, in accordance with prior literature. The primary outcome was any postpartum ED visit or hospital readmission within 6 weeks of cesarean birth. Modified Poisson regression was used to estimate risk ratios (RR), adjusting for confounders.

Results:
Among 129 participants, 41% reported ≥1 ACE, and 19% had a postpartum ED visit or readmission. Postpartum ED visits or readmissions were more common among those with ACEs compared to those without (36% vs 8%, Figure 1). Compared to participants without ACEs, those with ≥1 ACE had an increased risk of ED visit or readmission (aRR 5.50, 95% CI 2.41–12.6). Similarly, those with a high ACEs burden (≥4) had increased risk (aRR 3.28, 95% CI 1.55–6.93, p=0.002), compared to those with < 4 ACEs (Table 1). All ACE trauma subtypes were independently associated with increased risk of postpartum ED visit or readmission (Table 1).

Conclusion:

ACEs were strongly associated with increased postpartum ED visits and hospital readmissions following cesarean birth. Trauma-informed care programs that incorporate routine ACE screening into peripartum care may help identify those at risk of postpartum complications and mitigate preventable postpartum hospital encounters in this population.