Britt Abby, Higgins Melinda, Dunlop Anne, Michopoulos Vasiliki, Carlson Nicole
Emory University Nell Hodgson Woodruff School of Nursing, Atlanta, Georgia.
Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia.
J Midwifery Womens Health. 2025 Jul-Aug;70(4):629-639. doi: 10.1111/jmwh.13762. Epub 2025 Jun 3.
Black pregnant people are disproportionately impacted by childhood maltreatment and maternal morbidity and mortality related to labor dysfunction. One largely unexplored link between these disparities is the maternal oxytocin system, which is affected by childhood maltreatment and integral to labor. The current study examines relationships between maternal childhood maltreatment, labor duration, and intrapartum synthetic oxytocin requirements.
This is a secondary data analysis of a completed prospective cohort study involving Black pregnant people recruited from 2 academic medical centers in Atlanta, Georgia. Participants had no health complications, term labor, and a singleton fetus in cephalic presentation (N = 109). Childhood maltreatment was assessed using the Childhood Trauma Questionnaire. Labor duration and synthetic oxytocin data were collected via health record abstraction. Associations were examined between childhood maltreatment, labor duration, and synthetic oxytocin requirements after stratification by mode of labor onset.
No significant associations were found between childhood maltreatment and labor duration in the total sample (N = 109). However, among the induction of labor sample (n = 47), both small-to-moderate and larger associations were found between childhood emotional (β, 0.253; P = .073) and physical (β, 0.398; P = .003) abuse and labor duration after adjusting for parity, epidural analgesia use, and body mass index. Additionally, in the labor induction sample, there were significant, moderate-to-large associations between higher levels of childhood physical abuse with higher intrapartum synthetic oxytocin dose (ρ, 0.433; P = .002), longer duration (ρ, 0.381; P = .008), and higher average dose per hour (ρ, 0.312; P = .033).
In a sample of Black pregnant people who underwent labor induction, childhood emotional and physical abuse were associated with longer labor duration. Childhood physical abuse was associated with higher synthetic oxytocin requirements. Further research is needed to understand the potential relationships between maternal childhood maltreatment and labor outcomes to inform future interventions toward birth outcome equity.
黑人孕妇在童年期受虐待以及与产程功能障碍相关的孕产妇发病率和死亡率方面受到的影响尤为严重。这些差异之间一个很大程度上未被探索的联系是母体催产素系统，该系统受童年期虐待影响且对分娩至关重要。本研究考察了母体童年期虐待、产程时长和产时合成催产素需求量之间的关系。
这是一项对已完成的前瞻性队列研究的二次数据分析，研究对象是从佐治亚州亚特兰大的2个学术医疗中心招募的黑人孕妇。参与者无健康并发症、足月分娩且单胎头先露（N = 109）。使用儿童创伤问卷评估童年期虐待情况。通过查阅健康记录收集产程时长和合成催产素数据。在按分娩发动方式分层后，考察童年期虐待、产程时长和合成催产素需求量之间的关联。
在总样本（N = 109）中，未发现童年期虐待与产程时长之间存在显著关联。然而，在引产样本（n = 47）中，在调整了产次、硬膜外镇痛使用情况和体重指数后，发现童年期情感虐待（β，0.253；P = 0.073）和身体虐待（β，0.398；P = 0.003）与产程时长之间存在小到中等以及较大的关联。此外，在引产样本中，童年期身体虐待程度较高与产时合成催产素剂量较高（ρ，0.433；P = 0.002）、产程较长（ρ，0.381；P = 0.008）以及每小时平均剂量较高（ρ，0.312；P = 0.033）之间存在显著的中等至较大关联。
在接受引产的黑人孕妇样本中，童年期情感和身体虐待与产程较长有关。童年期身体虐待与合成催产素需求量较高有关。需要进一步研究以了解母体童年期虐待与分娩结局之间的潜在关系，为未来实现分娩结局公平的干预措施提供信息。
