Comprehensive Summary
This paper, written by I. Zhu et al, explores the effect of adverse childhood experiences (ACEs) in mental health and pregnancy loss in rural Chinese Women. A cross-sectional study was performed using a questionnaire sent out to 2880 women in Henan, China between the months of June and July 2024. Participants were asked to self-report any ACEs, pregnancy loss history and depression/anxiety scales. A Double Machine Learning (DML) framework with Random Forest, Lasso, and XGBoost was used in order to estimate causal effects as well as heterogeneity. Results showed that women with at least one adverse childhood experience had an average increase of 0.133 pregnancy losses compared to those without ACEs. This effect was strongest in both older and less-educated women, while younger women with ACEs were more likely to have mental health issues.
Outcomes and Implications
This paper highlights how early life traumas can contribute to lifelong consequences, whether it be biological or psychological especially in vulnerable rural women, a heavily understudied population. Clinical applications include implementing a screening for ACEs as a standard in primary and reproductive healthcare. I. Zhu et al also calls for centers integrating mental health support into material clinics.