Freedman Alexa A, Cammack Alison L, Temple Jeff R, Silver Robert M, Dudley Donald J, Stoll Barbara J, Varner Michael W, Saade George R, Conway Deborah, Goldenberg Robert L, Hogue Carol J
Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA.
Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA.
Ann Epidemiol. 2017 Aug;27(8):459-465.e2. doi: 10.1016/j.annepidem.2017.07.005. Epub 2017 Jul 13.
To determine the association between maternal exposure to childhood maltreatment (CM) and risk of stillbirth (fetal death at or after 20 weeks' gestation).
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 less than 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.
Generally, there was no association between CM and stillbirth, except for the emotional neglect subscale (OR: 1.93; 95% CI: 1.17, 3.19).
Childhood neglect is understudied in comparison to abuse and should be included in the future studies of associations between CM and pregnancy outcomes, including stillbirth.
确定母亲童年期受虐待(CM)与死产风险(妊娠20周及以后的胎儿死亡)之间的关联。
2006 - 2008年在美国进行的基于人群的死产协作研究网络(SCRN)病例对照研究,以及2009年进行的随访研究,即研究索引死产后的SCRN - 结果(SCRN - OASIS)。病例(n = 133)包括经历死产的女性,不包括因遗传/结构或脐带异常导致的死产以及产时死产。对照(n = 500)包括分娩健康足月活产的女性(不包括妊娠少于37周、新生儿重症监护病房入院或死亡的分娩)。在SCRN - OASIS研究期间使用儿童创伤问卷测量CM暴露情况。使用逻辑回归分析CM五个子量表(身体虐待、身体忽视、情感虐待、情感忽视和性虐待)的二分得分以及CM暴露的总体测量值。
一般而言,CM与死产之间无关联,但情感忽视子量表除外(比值比:1.93;95%置信区间:1.17,3.19)。
与虐待相比,童年期忽视的研究较少,应纳入未来关于CM与包括死产在内的妊娠结局之间关联的研究中。