Lund J I, Day K L, Schmidt L A, Saigal S, Van Lieshout R J
1Department of Psychiatry and Behavioural Neurosciences,McMaster University,Hamilton,ON,Canada.
2Department of Psychology, Neuroscience and Behaviour,McMaster University,Hamilton,ON,Canada.
J Dev Orig Health Dis. 2016 Dec;7(6):581-587. doi: 10.1017/S2040174416000532. Epub 2016 Sep 19.
Preterm birth and exposure to childhood sexual abuse (CSA) are early physiological and psychological adversities that have been linked to reduced social functioning across the lifespan. However, the joint effects of being born preterm and being exposed to CSA on adult social outcomes remains unclear. We sought to determine the impact of exposure to both preterm birth and CSA on adult social functioning in a group of 179 extremely low birth weight (ELBW; 2500 g) participants in the fourth decade of life. Social outcome data from a prospective, longitudinal, population-based Canadian birth cohort initiated between the years of 1977 and 1982 were examined. At age 29-36 years, ELBW survivors who experienced CSA reported poorer relationships with their partner, worse family functioning, greater loneliness, lower self-esteem and had higher rates of avoidant personality problems than those who had not experienced CSA. Birth weight status was also found to moderate associations between CSA and self-esteem (P=0.032), loneliness (P=0.021) and family functioning (P=0.060), such that the adverse effects of CSA were amplified in ELBW survivors. Exposure to CSA appears to augment the adult social risks associated with perinatal adversity. Individuals born preterm and exposed to CSA appear to be a group at particularly high risk for adverse social outcomes in adulthood.
早产和童年期遭受性虐待（CSA）是早期的生理和心理逆境，与一生的社会功能降低有关。然而，早产和遭受CSA对成人社会结局的联合影响仍不清楚。我们试图确定在一组179名处于生命第四个十年的极低出生体重（ELBW；<2500克）参与者中，早产和CSA暴露对成人社会功能的影响。我们研究了1977年至1982年间启动的一项基于加拿大人群的前瞻性纵向出生队列的社会结局数据。在29至36岁时，经历过CSA的ELBW幸存者报告称，他们与伴侣的关系较差、家庭功能较差、孤独感更强、自尊较低，且回避型人格问题的发生率高于未经历过CSA的人。出生体重状况也被发现会调节CSA与自尊（P=0.032）、孤独感（P=0.021）和家庭功能（P=0.060）之间的关联，因此CSA的不利影响在ELBW幸存者中被放大。暴露于CSA似乎会增加与围产期逆境相关的成人社会风险。早产且暴露于CSA的个体似乎是成年期出现不良社会结局的特别高危人群。
