Risk factors for unfavorable pregnancy outcome in women with adverse childhood experiences

Abstract

Aims: To explore the association between childhood sexual abuse (CSA), physical abuse, as well as other adverse childhood experiences (ACE), and different obstetrical risk factors/behaviors. Methods: In this cohort study, obstetrical risk factors and perinatal outcome in 85 women exposed to CSA were compared to 170 matched unexposed women. CSA, physical abuse, and ACE were explored by face-to-face interviews and by questionnaire. Data on perinatal outcome were extracted from medical charts. Fisher's exact, χ 2 -test, and multiple logistic regression were used for statistical analysis. Results: During pregnancy women with CSA experiences were significantly more often smoking (31.7%/9.4%; P < 0.0001), had partners abusing drugs (10.6%/1.2%; P < 0.0005), experienced physical (16.5%/0; P < 0.0001), sexual (12.9%/0; P < 0.0001), and emotional abuse (44.7%/1.7%; P < 0.0001), reported depression (24.7%/1.8%; P < 0.0001), and suicidal ideation (10.6%/0; P < 0.0001) than women without CSA experiences. Differences in risk factors were more often correlated with physical than with sexual abuse during childhood. The probability for premature delivery was associated with CSA, physical abuse and ACE as well as with several of the risk factors investigated. Conclusion: Women with CSA, physical, and ACE present with a variety of abuse-associated obstetrical risk factors and an increased risk for premature delivery. Therefore, all types of abusive and other ACE should be considered in prenatal care.

Childhood abuse increases the risk of depressive and anxiety symptoms and history of suicidal behavior in Mexican pregnant women

“…As in other studies, 7 we found that CSA was associated with depressive (OR = 2.60) and anxiety symptoms (OR = 2.58). These associations remained significant even after adjusting for mediating and confounding factors.…”

“…As a whole, this work has found that having a history of childhood physical abuse (CPA) and/or sexual abuse (CSA) is related to suicidal ideation and/or suicide attempts during pregnancy. 1,7 However, findings have been mixed regarding the relationship between childhood abuse and increased risk of prenatal depression or anxiety. Leeners et al 6 conducted a systematic literature review in 2006 and concluded that pregnant women with a history of CSA were more likely to experience depression and anxiety.…”

“…However, subsequent studies yielded conflicting findings. While some studies found a history of CSA and/or CPA to be associated with depression during pregnancy, [7][8][9][10] others have failed to detect a link. 11,12 To our knowledge, only one study examined the effect of a history of childhood verbal abuse (CVA), but did not find significant associations with depression.…”

Adverse Childhood Experiences Influence Development of Pain During Pregnancy

“…This suggests that information about accumulated ACE in early pregnancy could be useful to identify women who are at risk of developing pain with higher intensity and large distributions later on, as these are known risk factors for transition to chronic pain (19)(20)(21). In addition, among women with pain during pregnancy, information about ACE is warranted because of previously described unfavorable pregnancy outcomes (9,11).…”

“…Among pregnant women exposed to childhood sexual abuse more obstetrical complications, backache, headache and leg cramps were reported during pregnancy and their risk of being hospitalized or of giving birth preterm was increased (9,10). In a small case-control study childhood abuse, including sexual and physical abuse, was reported to influence obstetric and neonatal complications such as preterm birth, depression and suicidal ideation (11). In the same study and in two large cohort studies it was reported that among pregnant women childhood sexual abuse was a traumatic event with greater negative long-term effects than other traumatic events (9,12,13).…”