The effects of maternal stress during pregnancy may depend, in part, on the timing in gestation of the occurrence of stress. The aim of the present study was to examine the effect of stage of gestation on maternal psychophysiological responses to stress using a standardized laboratory paradigm and on the cortisol response to awakening (CAR). A longitudinal design was employed to quantify maternal psychophysiological stress reactivity [changes in heart rate (HR), blood pressure, salivary cortisol, and psychological distress in response to the trier social stress test (TSST)] and the CAR at approximately 17 and 31 weeks gestation in a sample of 148 women. To account for the possible effects of habituation when being exposed to the same stress protocol twice, a non-pregnant comparison group (CG, N = 36) also underwent these assessments at two time points, with a comparable time interval between the assessments. In both groups, the TSST elicited significant changes in maternal HR, mean arterial pressure, and psychological distress levels but not a significant increase in cortisol levels. Among the pregnant women (pregnant group(PG)), the stressor-induced increases in HR, blood pressure, and psychological distress were significantly lower at the second (31 weeks gestation) compared to the first (17 weeks gestation) assessment of pregnancy (all p < 0.01). The maternal CAR was also significantly attenuated in later compared to earlier gestation (p = 0.003). In the CG, there were no significant differences in psychophysiological stress responses and in the CAR across the two assessments. Among pregnant women there is a progressive attenuation of psychophysiological stress responses with advancing gestation. This attenuation is unlikely to be attributable to habituation. Individual differences in the degree of attenuation of stress responses over gestation may represent a novel marker of stress susceptibility in human pregnancy.

BACKGROUND: This study compares rates of posttraumatic stress disorder (PTSD) in female veterans who had military sexual trauma (MST) with rates of PTSD in women veterans with all other types of trauma.

Retrospective reports of exposure to childhood trauma indicate it is common. There is growing interest in relationships between maternal exposure to childhood adversity, perinatal mental health, and pregnancy outcomes. The goal of this study was to describe the self-reported prevalence and test-retest reliability of exposure to childhood maltreatment using the Childhood Trauma Questionnaire among adult women around the time of pregnancy. A substantial proportion of women reported exposure to maltreatment and reliability was generally at least moderate, indicating consistent reporting.

Objective The purpose of this study was to examine associations between chronic preconception psychosocial and socioeconomic stress with bacterial vaginosis (BV) during pregnancy. Study Design Using univariate and multivariate logistic regression, childhood abuse and neglect, chronic discrimination, childhood socioeconomic status, potential confounders, and BV were assessed at 14-16 and 19-22 weeks gestation in a cohort of 312 pregnant women. Results Persistent BV (BV positive at both time points versus no BV at either time point) was associated with childhood sexual abuse (CSA), chronic discrimination, and lack of parental home ownership. These associations were still present after covarying for current perceived stress, socioeconomic status, and other potential confounders. Conclusion There is evidence that BV during pregnancy is independently linked with early life psychosocial adversity, suggesting that a life course perspective may be important in elucidating determinants of perinatal outcomes.

Purpose To determine the association between maternal exposure to childhood maltreatment (CM) and risk of stillbirth (≥ 20 weeks’ gestation). Methods Population-based case-control study from the Stillbirth Collaborative Research Network (SCRN) conducted in 2006–2008, and the follow-up study, SCRN-Outcomes after Study Index Stillbirth (SCRN-OASIS), conducted in 2009 in the United States. Cases (n = 133) included women who experienced a stillbirth, excluding stillbirths attributed to genetic/structural or umbilical cord abnormalities and intrapartum stillbirths. Controls (n = 500) included women delivering a healthy term live birth (excluding births <37 weeks gestation, neonatal intensive care unit admission, or death). CM exposure was measured using the Childhood Trauma Questionnaire, administered during the SCRN-OASIS study. Dichotomized scores for five subscales of CM (physical abuse, physical neglect, emotional abuse, emotional neglect, and sexual abuse) and an overall measure of CM exposure were analyzed using logistic regression. Results Generally, there was no association between CM and stillbirth, except for the emotional neglect subscale (OR: 1.93; 95% CI: 1.17, 3.19). Conclusions Childhood neglect is understudied in comparison to abuse and should be included in future studies of associations between CM and pregnancy outcomes, including stillbirth.

Purpose: Childhood adversity is associated with increased risk of adult disease, including type 2 diabetes and hypertension. However, little is known about potential associations between childhood adversity and adverse pregnancy outcomes. The goal of this study is to examine the

Objectives: Preterm birth (PTB) is a leading cause of infant morbidity and mortality. One goal of Healthy People 2020 is to understand the role of preconception lifecourse exposures in relation to pregnancy outcomes, including PTB. The objective of this study was to examine the relationship between maternal exposure to multiple forms of childhood abuse and PTB and very preterm birth (vPTB), utilizing a national, population-based sample.Methods: This study utilized retrospective self-reported maternal exposure to parent/adult caregiver perpetrated emotional, physical, and sexual abuse; non-parental/adult caregiver perpetrated sexual abuse; and history of PTB and vPTB in the National Longitudinal Study of Adolescent to Adult Health. The cross-sectional analytic study population consisted of first deliveries to 4,181 nulliparous women (mean age at time of delivery= 21.7 years).Results: With one exception, we did not observe associations between experiences of child abuse and the likelihood of PTB or vPTB. Only sexual abuse, accompanied by physical force and perpetrated by a non-parent/adult caregiver, was associated with an increased odds of vPTB (aOR= 1.94 (95% CI:1.10, 3.44)), particularly in women for whom abuse began after age 9 (aOR=2.32 (95% CI: 1.25, 4.28)). Conclusions for Practice:The relationship between maternal exposure to child abuse and PTB may be limited to specific abuse and PTB subtypes, namely parent/caregiver perpetrated sexual abuse by force and vPTB. Future studies should also examine possible effect modifiers, such as maternal age and resilience, which may have the potential to inform interventions that can mitigate effects of maternal early life adversity.

Objective Evidence stemming largely from retrospective studies suggests that childhood adversity (CA) is associated with earlier age at menarche, a marker of pubertal timing, among girls. Little is known about associations with pubertal tempo among boys or racial/ethnic minorities. We examined the association between CA and timing and tempo of pubertal development among boys and girls. Methods The Boricua Youth Study is a longitudinal study of Puerto Rican youth residing in the San Juan metro area in Puerto Rico and the South Bronx, New York. CA was based on caretaker reports of parental loss and parental maladjustment and youth reports of child maltreatment and exposure to violence. Youth completed the Pubertal Development Scale (PDS) yearly for 3 years. In linear mixed models stratified by sex, we examined the association between CA and pubertal timing and tempo, adjusting for site, socioeconomic status, and age. Results Among the 1949 children who were 8 years or older by wave 3, cumulative CA was associated with higher PDS scores among girls compared with girls not exposed to CA (PDS score: 2.63 [95% confidence interval {CI} = 2.55–2.71] versus 2.48 [95% CI = 2.37–2.58]). In contrast, among boys, experiencing adversities was associated with lower pubertal developmental stage or later timing (PDS: 1.77 [95% CI = 1.67–1.87] versus 1.97 [95% CI = 1.85–2.10]) compared with those not exposed to adversities. Conclusions Associations between CA and pubertal development may vary by sex. Understanding the etiological role of adversities on pubertal development and identifying targets for intervention are of utmost importance in ameliorating the impact of CA on child health.