Department of Epidemiology, Louisiana State University School of Public Health, New Orleans, LA, USA.
Department of Global Biostatistics and Data Science, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
Matern Child Health J. 2021 Mar;25(3):479-486. doi: 10.1007/s10995-020-03079-y. Epub 2021 Jan 3.
To investigate whether adverse childhood experiences are associated with miscarriage.
The Gulf Resilience on Women's Health Consortium recruited from clinics and community organizations in Southern Louisiana, 2011-2016. Data from 1511 reproductive-aged women with at least one pregnancy were analyzed. Adverse childhood experiences including abuse, neglect, and family dysfunction, as a child (< age 12), and as an adolescent (12-17), were assessed. Outcome measures were self-reported miscarriage at first pregnancy and at any pregnancy, analyzed with logistic regression with adjustment for maternal age at pregnancy, race, BMI, education, marital and smoking status.
Women reporting four or more adversities as a child and as a teen had higher odds of experiencing miscarriage at first pregnancy (AOR 1.71, 95% CI 1.00-2.90; AOR 1.73, 95% CI 1.05-2.87) and miscarriage at any pregnancy (AOR 1.74, 95% CI 1.16-2.62; OR 1.65, 95% CI 1.10-2.45) compared to those with no adverse childhood experiences. Similar patterns of association were seen for other ACE sub-categories.
Childhood adversities were associated with miscarriage. Further research is needed on the pathways which created this association, including psychological, behavioral, and physiological mechanisms and factors which can mitigate the effects of these outcomes.
探讨儿童期不良经历是否与流产有关。
2011-2016 年,海湾妇女健康弹性联盟在路易斯安那州南部的诊所和社区组织中招募了研究对象。对 1511 名至少有一次妊娠的育龄妇女的数据进行了分析。儿童期(<12 岁)和青少年期(12-17 岁)的不良儿童经历包括虐待、忽视和家庭功能障碍。结局指标为首次妊娠和任何妊娠的自然流产,采用 logistic 回归分析,调整了妊娠时母亲的年龄、种族、BMI、教育程度、婚姻状况和吸烟状况。
报告儿童期和青少年期有 4 种或更多不良经历的女性首次妊娠发生流产的几率更高(校正比值比[OR] 1.71,95%可信区间[CI] 1.00-2.90;OR 1.73,95%CI 1.05-2.87)和任何妊娠发生流产的几率更高(校正 OR 1.74,95%CI 1.16-2.62;OR 1.65,95%CI 1.10-2.45),与无儿童期不良经历的女性相比。其他 ACE 亚类也存在类似的关联模式。
儿童期逆境与流产有关。需要进一步研究导致这种关联的途径,包括心理、行为和生理机制以及可以减轻这些结果影响的因素。