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Screening for Adverse Childhood Experiences in an OBGYN Resident Clinic

Resident: Hillary O'Brien, MD

Faculty Advisor: Katie Smith, MD, MS

Background

Adverse childhood experiences (ACEs) are adversities faced prior to the age of eighteen which can significantly increase morbidity and mortality throughout a person’s life. ACEs are prevalent across all demographics with approximately 62% of people having experienced at least one ACE. Increasing numbers of ACEs have implications for obstetric and gynecologic outcomes including increased risk of mental health disorders, sexually transmitted infections, preterm birth, overactive bladder, painful bladder syndrome, and many more. The purpose of this study is to describe the prevalence of ACEs and demographic characteristics of those patients who have experienced ACEs within the OU OBGYN Resident Clinic. 

Methods

Screening for adverse childhood experiences was implemented as routine practice within the OU OBGYN Resident clinic. The survey results and demographic information were then collected as part of a retrospective descriptive chart review. 

Results

Approximately one in four patients (26%) experienced four or more adverse childhood experiences. The most prevalent ACE was losing a parent through divorce, abandonment, death, or other reasons. The least common ACEs were those describing physical and emotional neglect. Of those patients who reported that their ACEs affected their health “a lot,” 100% of them experienced four or more ACEs.

Conclusions

ACEs are common throughout the OU OBGYN Resident Clinic patient population, and patients were willing to be screened. This study helps establish a foundation for integration of screening into the clinic workflow and support for expanding screening across other OBGYN clinics.








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