Maternal exposure to childhood maltreatment and risk of stillbirth

Abstract

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.

Adverse childhood experiences and poor birth outcomes in a diverse, low-income sample

“…ACEs like emotional neglect, physical abuse, and sexual abuse have been linked to an increased risk of poor birth outcomes such as pregnancy loss and preterm birth [8, 9]. Yet, despite the surge of ACE research over the last two decades, surprisingly few studies have examined the cumulative impact of ACEs on birth outcomes.…”

An Integrative Review of Adverse Childhood Experiences and Reproductive Traumas of Infertility and Pregnancy Loss

“…Four studies reported associations between infertility and at least one ACE with mixed results 17 . 30, 31 , 38 Gleason et al 30 reported a positive association between infertility and ACEs. Their study included 1652 women from the National Longitudinal Survey of Youth's 1997 cohort and found that those with a history of childhood stressful life events (which included ACE) had an increased odds of infertility ranging from an OR of 1.20 (95% CI, 0.9‐1.64) for 2 ACEs to an OR of 1.88 (95% CI, 1.38‐2.57) for 4 or more ACEs 30 .…”

“…A larger percentage of Hispanic and Black women in the studies of this review were more likely to report infertility or pregnancy loss and report lower income and other factors associated with SDOH than White women. 16,30,34,35,37,38 In the United States, previous evidence has suggested a concerning disparity that Black and Hispanic women are more at risk for experiencing ACEs than White women. 49 Furthermore, Wamser-Nanney 38 reported that individuals from racial or ethnically diverse populations were not associated with the use of infertility treatments; however, previous evidence suggested infertility treatments in the United States were disproportionally received by White individuals.…”

Adverse childhood experiences and lifetime adverse maternal outcomes (gestational diabetes and hypertensive disorders of pregnancy) in the Hispanic Community Health Study/Study of Latinos

“…23 Further, the relationship between ACEs and perinatal outcomes may differ among non-white women, due to plateauing effects of additional stressors that are more prevalent among non-white women (e.g., discrimination). 25,36 This project has several important limitations. First, measures of adverse childhood experiences and pregnancy complications were retrospectively self-reported.…”

“…1,17 Chronic inflammation, unhealthy behaviors and altered stress regulatory pathways are known or suspected risk factors for HDP [18][19][20][21] and gestational diabetes. 22 Despite biologic plausibility, prior research of the relationship between ACEs and pregnancy complications has been inconclusive, with some studies reporting associations between cumulative ACE exposure and adverse pregnancy outcomes and other studies finding evidence of association only within specific subgroups or for specific types of childhood adversity [23][24][25][26][27][28][29][30] Understanding possible links between adverse childhood experiences and pregnancy complications will inform efforts to improve maternal health during and following pregnancy. Thus, the goal of this analysis is to estimate the association between cumulative ACEs and lifetime adverse maternal outcomes (gestational diabetes and HDP) among Hispanic/Latina women using data from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) and its Sociocultural Ancillary Study (SCAS).…”