Childhood maltreatment and pre-pregnancy obesity: a comparison of obese, overweight, and normal weight pregnant women

Abstract

Pre-pregnancy overweight and obesity is associated with poor health outcomes for the mother and the child. General population studies suggest that childhood maltreatment is associated with obesity in adulthood. The aim of our study was to examine the association between pre-pregnancy overweight and obesity and a history of childhood abuse or neglect including different stages of severity of abuse and neglect. Three hundred twenty-six normal weight, overweight, or obese pregnant women reported demographic data, height and weight, and general psychological distress at 18-22 weeks of gestation. Childhood maltreatment was assessed using the Childhood Trauma Questionnaire. Associations were examined using logistic regression analyses and a reference group of normal weight women. Fifty percent reported a history of abuse or neglect. After adjusting for age, education, income, marital status, and the number of previous children, pre-pregnancy overweight and obesity were strongly associated with severe physical abuse (overweight: OR = 8.33, 95% CI 1.48-47.03; obesity: OR = 6.31, 95% CI 1.06-37.60). Women with severe physical neglect (OR = 4.25, 95% CI 1.23-14.74) were at increased risk of pregnancy overweight. We found a dose-response relationship between physical abuse and pre-pregnancy overweight and obesity. Whereas other studies report an association between childhood maltreatment and pre-pregnancy obesity, this is the first study that found an association between childhood maltreatment and pre-pregnancy overweight. Considering the severe health risks of pre-pregnancy overweight and obesity and the long-term consequences of childhood maltreatment, affected women constitute a subgroup with special needs in prenatal care. Further research is needed to improve the understanding of the underlying mechanisms.

Examination of the role of obesity in the association between childhood trauma and inflammation during pregnancy.

“…Based on a model of psychoneuroimmunology during pregnancy (Christian, 2015) and existing literature, the potential mediating role of pre-pregnancy body composition in the observed associations between trauma exposure and inflammation was of interest. Prior studies have linked childhood abuse and neglect with pre-pregnancy overweight and obesity (Hollingsworth, Callaway, Duhig, Matheson, & Scott, 2012; Nagl, Steinig, Klinitzke, Stepan, & Kersting, 2016; Ranchod et al, 2016). Further, data from 326 non-pregnant women demonstrated that observed associations between child abuse and neglect exposure with elevated serum CRP were mediated by BMI (Matthews, et al, 2014).…”

Maternal History of Child Abuse and Obesity Risk in Offspring: Mediation by Weight in Pregnancy

“…However, our results are consistent with other findings of only physical abuse being associated with adult obesity and that other ACE exposures may confer different effects than physical abuse. [6][7][8]12 The prevalence of physical abuse in this study was similar to that among women in the BRFSS, but the prevalences of household mental illness and alcoholism were lower by 8.1 and 4.6 percentage points, respectively, suggesting that our study group may have underreported these exposures 36 ; therefore, we cannot confidently rule out their importance. We were also unable to assess other types of abuse and neglect, which could confound the association between physical abuse and early childhood obesity or be independent risk factors.…”

“…4,5 In numerous additional studies, researchers have also found adverse childhood experiences (ACE) to be associated with obesity in adulthood. [6][7][8][9] Most recently, adversity in childhood has been associated with high prepregnancy BMI and excessive weight gain during pregnancy [10][11][12] as well as offspring obesity. 13 We sought to bridge the bodies of evidence connecting childhood adversity with maternal obesity and maternal obesity with child obesity.…”

Associations of childhood maltreatment with pre-pregnancy obesity and maternal postpartum mental health: a cross-sectional study

“…Less is known about these associations during pregnancy. We are aware of only two studies with a focus on associations between different types of childhood maltreatment and obesity among pregnant women [ 34 , 35 ] consistently suggesting an increased risk of pre-pregnancy obesity among women with a history of childhood physical abuse. Findings for emotional abuse are inconsistent with one study suggesting a positive association [ 34 ] and the other suggesting no association [ 35 ].…”

“…We are aware of only two studies with a focus on associations between different types of childhood maltreatment and obesity among pregnant women [ 34 , 35 ] consistently suggesting an increased risk of pre-pregnancy obesity among women with a history of childhood physical abuse. Findings for emotional abuse are inconsistent with one study suggesting a positive association [ 34 ] and the other suggesting no association [ 35 ]. Particularly childhood abuse has also been found to be associated with ante- and postnatal depression, anxiety and generalized anxiety disorder among pregnant women [ 20 , 30 , 36 – 38 ].…”