Department of Clinical Health Psychology, University of Manitoba, Canada; Department of Psychology, University of Toronto Scarborough, Canada.
Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Canada; Department of Psychology, University of Manitoba, Canada.
Gen Hosp Psychiatry. 2021 May-Jun;70:109-115. doi: 10.1016/j.genhosppsych.2021.02.009. Epub 2021 Feb 22.
A history of childhood maltreatment is associated with increased risk of perinatal complications, with research primarily focused on childhood sexual abuse. Limited research has examined the relationship between different types of childhood maltreatment on perinatal complications, particularly in population-based samples.
This study examined the association between childhood maltreatment and self-reported perinatal complications in a sample of pregnant and postpartum women (n = 1279) drawn from the 2012-2013 NESARC-III, a nationally representative survey of United States adults.
Nearly half (45%) of pregnant or postpartum women reported at least one form of childhood maltreatment and a quarter (24.6%) of these women experienced a perinatal complication compared to 13.5% of women without a history of childhood maltreatment. Exposure to any childhood maltreatment, childhood sexual abuse and intimate partner violence (IPV) during childhood were significantly associated with increased odds of perinatal complications after adjusting for sociodemographic characteristics and lifetime psychiatric disorders (AOR ranged from 1.87 to 2.09). Experiencing two or more types of childhood maltreatment (compared to none) was also associated with increased odds of perinatal complications (AOR 2.18 [99% CI = 1.22, 3.90]).
This association may be explained by vulnerability to physical diseases/complications due to persistent changes in biological stress systems, physical injuries from abuse, or as a result of traumatic memories triggered by pregnancy and childbirth. Findings highlight one of many negative sequelae of childhood maltreatment and the importance of promoting healthcare provider awareness of this association so they can provide appropriate interventions when needed.
童年期虐待史与围产期并发症的风险增加相关，研究主要集中在儿童期性虐待上。有限的研究调查了不同类型的儿童虐待与围产期并发症之间的关系，特别是在基于人群的样本中。
本研究在 2012-2013 年 NESARC-III 中抽取了一组怀孕和产后妇女（n=1279），该研究是一项针对美国成年人的全国代表性调查，研究了儿童虐待与自我报告的围产期并发症之间的关联。
近一半（45%）的怀孕或产后妇女报告至少有一种形式的儿童虐待，其中 24.6%的妇女经历了围产期并发症，而没有儿童虐待史的妇女这一比例为 13.5%。在调整了社会人口特征和终身精神障碍后，暴露于任何儿童虐待、儿童期性虐待和亲密伴侣暴力（IPV）与围产期并发症的发生几率增加显著相关（AOR 范围为 1.87 至 2.09）。经历两种或两种以上类型的儿童虐待（与无虐待相比）也与围产期并发症的发生几率增加相关（AOR 2.18 [99%CI=1.22, 3.90]）。
这种关联可能是由于生物应激系统的持续变化导致身体疾病/并发症的易感性、虐待造成的身体伤害，或由于怀孕和分娩引发的创伤记忆所致。研究结果突出了儿童虐待的许多负面影响之一，强调了提高医疗保健提供者对这种关联的认识的重要性，以便在需要时提供适当的干预措施。
