Department of Educational and Counselling Psychology, McGill University, Montréal, QC.
Department of Sexology, Université du Québec à Montréal, Montréal, QC.
J Obstet Gynaecol Can. 2022 May;44(5):496-502. doi: 10.1016/j.jogc.2021.11.013. Epub 2021 Dec 15.
This study explored the pathways underlying the relationships between child maltreatment (CM) subtypes (i.e., physical, sexual, and emotional abuse and neglect) and factors associated with a heightened risk of pregnancy complications by examining post-traumatic stress disorder (PTSD) symptoms as a potential mediator.
A sample of 98 pregnant parents between the ages of 18 and 29 years was recruited through social media and community organizations throughout Canada. Participants completed a series of surveys on their exposure to CM, PTSD symptoms, and pregnancy experiences on a secure online platform. Following data cleaning procedures, 85 participants were included in this study.
Four separate mediation analyses were conducted with child neglect, physical abuse, sexual abuse, and emotional abuse as factors associated with a heightened risk of pregnancy complications (i.e., a congregate score of limited prenatal care, weight gain concerns, smoking, second-hand smoke, alcohol consumption, substance use, and insufficient food intake during pregnancy). Each CM subtype was associated with increased PTSD symptoms, which were in turn associated with the presence of more factors known for increasing the risk of pregnancy complications. Neglect, physical abuse, sexual abuse, and emotional abuse were all indirectly associated with the presence of more factors associated with a heightened risk of pregnancy complications through their association with PTSD symptoms.
Findings from this study could encourage prenatal care providers to screen for CM history and PTSD symptoms. Furthermore, mental health treatment early in the prenatal period may improve pregnant parents' health and lower their risk of pregnancy complications.
本研究通过考察创伤后应激障碍（PTSD）症状作为潜在的中介因素，探讨了儿童虐待（CM）亚型（即身体、性和情感虐待以及忽视）与与妊娠并发症风险增加相关的因素之间关系的潜在途径。
通过社交媒体和加拿大各地的社区组织招募了 98 名年龄在 18 至 29 岁之间的孕妇父母作为研究对象。参与者在一个安全的在线平台上完成了一系列关于他们暴露于 CM、PTSD 症状和妊娠经历的调查。在进行数据清理程序后，共有 85 名参与者纳入本研究。
对儿童忽视、身体虐待、性虐待和情感虐待作为与妊娠并发症风险增加相关的因素（即产前护理受限的综合评分、体重增加问题、吸烟、二手烟、饮酒、药物使用和怀孕期间摄入不足的食物）进行了四项单独的中介分析。每种 CM 亚型都与 PTSD 症状增加有关，而 PTSD 症状又与增加妊娠并发症风险的更多因素的存在有关。忽视、身体虐待、性虐待和情感虐待均通过与 PTSD 症状的关联，与更多与妊娠并发症风险增加相关的因素的存在间接相关。
本研究的结果可能会鼓励产前保健提供者筛查 CM 史和 PTSD 症状。此外，在产前早期进行心理健康治疗可能会改善孕妇父母的健康状况，并降低他们的妊娠并发症风险。
