The Associations Between Maternal Adverse Childhood Experiences, Substance Use During Pregnancy and Poor Infant Outcomes: A Protocol for Systematic Review and Meta-Analysis

Abstract Background: Research suggests that maternal exposure to childhood adversity is associated with substance use during pregnancy and poor infant outcomes (i.e., premature birth, low birth weight). However, to date, no systematic review has synthesised the effect of ACEs on these three outcomes. Method: The framework for this review will be adapted from the guidelines laid out in the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) 2015 statement. The electronic databases to be searched will include: PubMed, SCOPUS, PsycInfo, Web of Science, and CINAHL and will be carried out by one reviewer. Studies that fit the pre-specified eligibility criteria will be screened, assessed, and extracted independently by two reviewers with discrepancies to be resolved by a third reviewer. The Newcastle-Ottawa Scale (NOS) for cross-sectional and cohort studies will be used to critically evaluate the methodological quality of the selected studies. If a sufficient number of studies are found to be comparable, a meta-analysis will be conducted using a random effects model. Discussion: This review will provide supporting evidence on the body of literature exploring the long-term and intergenerational consequences of adverse childhood experiences. The results of the review can help inform policies and interventions related to maternal health as well as early childhood development. The gaps identified in the review can also help inform recommendations for future research.