Karina_Shreffler

Shreffler

I share the commonly held American value that all children deserve the opportunity to pursue happy, healthy lives. Sadly, children in Oklahoma are at a higher risk for exposure to Adverse Childhood Experiences, and this exposure has been linked to a variety of risks for poor mental and physical health outcomes.

New research suggests that children born to mothers with higher ACEs also increase risks for outcomes such as preterm birth and early developmental delays. Why are the babies of mothers who experienced more trauma and adversity in their own lives at greater risk for poor birth outcomes than babies born to mothers with fewer ACEs?

Answering this question will provide targets for intervention so more of our children in Tulsa will be born healthy and able to reach their fullest potential.

To address this gap, I have been leading a National Institutes of Health-funded research study at Oklahoma State University-Tulsa in collaboration with researchers at other Tulsa universities, for the past two years: The Holistic Assessment of Tulsa Children’s Health Project.

I started with two hypotheses that might explain the intergenerational transmission of maternal ACEs.

First, there might be a behavioral explanation.

Teens and women with a history of abuse and trauma might not have used contraception as consistently, leading to delayed recognition of pregnancy and prenatal care and potentially more exposure to harmful substances during pregnancy, such as alcohol and tobacco. In addition, they may continue to use harmful substances even after being aware of the pregnancy because these can be coping mechanisms for people who have experienced ACEs.

The second hypothesis is biological.

Children and adults who were exposed to early life adversity and stress are more likely to have maladaptive stress response systems, meaning that their hormones may not be functioning how they should be. They also show more “wear and tear” of their bodily systems. Prenatal exposure to this less-than-optimal environment may increase risks for poor birth outcomes.

We are still in the process of collecting and analyzing our data, but early findings suggest both behaviors and biology matter.

For example, we have been paying close attention to our participants with a high number of ACEs, typically a score between 6 and 10.

Even though on average study participants are only about 25 years old, 57% of them reported having a chronic health condition, 53% were not planning to become pregnant and 17% continued to drink through pregnancy. Immune system biomarkers also indicate poor stress-response system functioning.

Perhaps most concerning was that this high ACEs group had about three times more miscarriages or stillbirths than participants with fewer ACEs. We are also learning about things that reduce some of the risks for these babies.

For example, even if a mother experienced many ACEs, if she also had someone in her life who provided unconditional love and support during childhood, her physical and mental well-being during pregnancy is improved. Additional findings are located on our website at hatchprojectok.com.

Understanding how to protect our youngest children is essential because it is how we will break the cycle of intergenerational trauma.

We can use these research findings to develop or adapt effective treatments that help pregnant women manage stress and programs that can help them build healthy coping and relationship skills.

Because of Oklahoma’s high rate of child health disparities and the community’s proven ability to collaborate across organizations, Tulsa has become the epicenter of childhood adversity research. As a result, the interventions and treatment informed by and created through this local research will be applied within Tulsa community organizations first.

The ultimate goal is helping mothers have healthy pregnancies so that the babies born into our community have the opportunity to reach their fullest potential, and in turn creating a brighter, healthier future for all Oklahoma children.


Dr. Karina Shreffler is a professor of human development and family science at Oklahoma State University-Tulsa and a researcher for the Center for Integrative Research on Childhood Adversity at OSU-CHS. She is project director for the $1.9 million HATCH: Holistic Assessment of Tulsa’s Children’s Health Project funded by the National Institutes of Health.

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