Lovett Sharonda M, Woo Jennifer M P, O'Brien Katie M, Parker Samantha E, Sandler Dale P
From the Department of Epidemiology, Boston University School of Public Health, Boston, MA.
Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC.
Epidemiology. 2025 Mar 1;36(2):149-159. doi: 10.1097/EDE.0000000000001817. Epub 2024 Dec 31.
Early-life trauma (before age of 18 years) is hypothesized to increase the risk for adverse pregnancy outcomes through stress pathways, yet epidemiologic findings are mixed.
Sister Study participants (US women aged 35-74 years enrolled 2003-2009) completed an adapted Brief Betrayal Trauma Survey at the first follow-up visit. Lifetime history of gestational diabetes mellitus (GDM) or hypertensive disorders of pregnancy (HDP: pregnancy-related high blood pressure, pre-eclampsia/toxemia, or eclampsia) in pregnancies lasting ≥20 weeks was self-reported. We used log-binomial regression to estimate relative risks (RR) and 95% confidence intervals (CIs) for the association between early-life trauma (modeled using conventional measures [e.g., any experience, substantive domains, individual types] and latent classes of co-occurring traumas) and GDM or HDP among 34,879 parous women.
Approximately, 4% of participants reported GDM and 11% reported HDP. Relative to no early-life trauma, the RRs for any were 1.1 (95% CI = 1.0, 1.3) for GDM and 1.2 (95% CI = 1.2, 1.3) for HDP. Women reporting physical trauma had the highest risk of GDM and HDP in comparison to other substantive domains. In analyses using latent classes of early-life trauma, high trauma was associated with an elevated risk of both GDM (RR = 1.9, 95% CI = 1.5, 2.6) and HDP (RR = 1.7, 95% CI = 1.4, 2.0) compared with low trauma.
Women experiencing high levels of trauma in early life were at higher risk of GDM and HDP, adding to a growing evidence base for this association.
早年创伤（18岁之前）被认为会通过应激途径增加不良妊娠结局的风险，但流行病学研究结果不一。
姐妹研究参与者（2003年至2009年招募的35至74岁美国女性）在首次随访时完成了一份改编后的简短背叛创伤调查问卷。自报了持续≥20周的妊娠中妊娠期糖尿病（GDM）或妊娠高血压疾病（HDP：妊娠相关高血压、先兆子痫/子痫前期或子痫）的终生病史。我们使用对数二项回归来估计34879名经产妇中早年创伤（使用传统测量方法[如任何经历、实质性领域、个体类型]和共现创伤的潜在类别建模）与GDM或HDP之间关联的相对风险（RR）和95%置信区间（CI）。
约4%的参与者报告患有GDM，11%报告患有HDP。与无早年创伤相比，GDM的RR为1.1（95%CI = 1.0, 1.3），HDP的RR为1.2（95%CI = 1.2, 1.3）。与其他实质性领域相比，报告身体创伤的女性患GDM和HDP的风险最高。在使用早年创伤潜在类别的分析中，与低创伤相比，高创伤与GDM（RR = 1.9，95%CI = 1.5, 2.6）和HDP（RR = 1.7，95%CI = 1.4, 2.0）的风险升高相关。
早年经历高水平创伤的女性患GDM和HDP的风险更高，这为这种关联增加了越来越多的证据基础。
