An exploratory study of whether pregnancy outcomes influence maternal self-reported history of child maltreatment

Abstract

Childhood maltreatment is common and has been increasingly studied in relation to perinatal outcomes. While retrospective self-report is convenient to use in studies assessing the impact of maltreatment on perinatal outcomes, it may be vulnerable to bias. We assessed bias in reporting of maltreatment with respect to women's experiences of adverse perinatal outcomes in a cohort of 230 women enrolled in studies of maternal mental illness. Each woman provided a self-reported history of childhood maltreatment via the Childhood Trauma Questionnaire at two time points: 1) the preconception or prenatal period and 2) the postpartum period. While most women's reports of maltreatment agreed, there was less agreement for physical neglect among women experiencing adverse perinatal outcomes. Further, among women who discrepantly reported maltreatment, those experiencing adverse pregnancy outcomes tended to report physical neglect after delivery but not before, and associations between physical neglect measured after delivery and adverse pregnancy outcomes were larger than associations that assessed physical neglect before delivery. There were larger associations between post-delivery measured maltreatment and perinatal outcomes among women who had not previously been pregnant and in those with higher postpartum depressive symptoms. Although additional larger studies in the general population are necessary to replicate these findings, they suggest retrospective reporting of childhood maltreatment, namely physical neglect, may be prone to systematic differential recall bias with respect to perinatal outcomes. Measures of childhood maltreatment reported before delivery may be needed to validly estimate associations between maternal exposure to childhood physical neglect and perinatal outcomes.

Associations Between Maternal Exposure to Child Abuse, Preterm Birth, and Very Preterm Birth in Young, Nulliparous Women

“…However, differential recall would be expected to induce a positive bias, which is inconsistent with the mostly null and statistically insignificant inverse associations found in this study. Also, a study that examined test-retest reliability in maternal self-reported history of child maltreatment before versus after pregnancy found poor agreement for physical neglect only (Cammack et al, 2016) and a related study also only found evidence of differential recall with respect to pregnancy outcomes for physical neglect (Cammack et al, 2018). Further, in spite of limitations to retrospective self-report, we note that retrospective measures have some advantages over longitudinally collected abuse measures from childhood, such as the lack of threats to validity from fear of consequences of abuse disclosure.…”

Childhood abuse, posttraumatic stress symptoms, and alcohol misuse among African-American women

“…Higher scores on each subscale are indicative of greater levels of the type of childhood abuse. The CTQ has demonstrated adequate reliability, including for African American women; alpha Cronbach's coefficients range from .85 to .93 for the abuse subscales and the abuse cumulative score (Allbaugh et al, 2017;Bernstein & Fink, 1998;Cammack et al, 2016). The CTQ has good divergent and convergent validity and its proposed five factors have been confirmed, reflecting good construct validity (Spinhoven et al, 2014).…”

Psychological Evaluations for Assisted Reproductive Intervention: Guidelines for Clinical Practice

“…Another one third are due to a problem with the man's fertility, known as "male factor infertility." The final one third are either due to a combination of factors or remain a mystery (American Society for Reproductive Medicine, 2019; Cammack et al, 2018;Galst, 2018;Kim & Hicks, 2015).…”