Associations Between Maternal Exposure to Child Abuse, Preterm Birth, and Very Preterm Birth in Young, Nulliparous Women

• Type of Material: Article
• Authors: AL Cammack, Emory University; Carol Hogue, Emory University; Carolyn Drews-Botsch, Emory University; Michael Kramer, Emory University; Bradley Pearce, Emory University
• Language: English
• Date: 2019-06-01
• Publisher: Springer/Plenum Publishers
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © Springer Science+Business Media, LLC, part of Springer Nature 2019
• Final Published Version (URL): http://dx.doi.org/10.1007/s10995-018-02709-w
• Title of Journal or Parent Work: Maternal and Child Health Journal
• Volume: 23
• Issue: 6
• Start Page: 847
• End Page: 857
• Grant/Funding Information: This study was supported by grants T32HD052460 and T03MC07651.; This research uses data from Add Health, a program project directed by Kathleen Mullan Harris and designed by J. Richard Udry, Peter S. Bearman, and Kathleen Mullan Harris at the University of North Carolina at Chapel Hill, and funded by grant P01-HD31921 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, with cooperative funding from 23 other federal agencies and foundations.
• Keywords: Stress; Public, Environmental & Occupational Health; Life Sciences & Biomedicine; Science & Technology; Trauma; Risk; Child abuse; Child maltreatment; Depressive symptoms; Delivery; Sexual abuse; Pregnancy; Preterm birth; Intimate partner violence; Victimization
• Research Categories: Health Sciences, Epidemiology; Gender Studies; Sociology, Public and Social Welfare

Abstract

Objectives: Preterm birth (PTB) is a leading cause of infant morbidity and mortality. One goal of Healthy People 2020 is to understand the role of preconception lifecourse exposures in relation to pregnancy outcomes, including PTB. The objective of this study was to examine the relationship between maternal exposure to multiple forms of childhood abuse and PTB and very preterm birth (vPTB), utilizing a national, population-based sample. Methods: This study utilized retrospective self-reported maternal exposure to parent/adult caregiver perpetrated emotional, physical, and sexual abuse; non-parental/adult caregiver perpetrated sexual abuse; and history of PTB and vPTB in the National Longitudinal Study of Adolescent to Adult Health. The cross-sectional analytic study population consisted of first deliveries to 4181 nulliparous women (mean age at time of delivery = 21.7 years). Results: With one exception, we did not observe associations between experiences of child abuse and the likelihood of PTB or vPTB. Only sexual abuse, accompanied by physical force and perpetrated by a non-parent/adult caregiver, was associated with an increased odds of vPTB (aOR = 1.94 (95% CI 1.10, 3.44)), particularly in women for whom abuse began after age 9 (aOR = 2.32 (95% CI 1.25, 4.28)). Conclusions for Practice: The relationship between maternal exposure to child abuse and PTB may be limited to specific abuse and PTB subtypes, namely non-parent/caregiver perpetrated sexual abuse by force and vPTB. Future studies should also examine possible effect modifiers, such as maternal age and resilience, which may have the potential to inform interventions that can mitigate effects of maternal early life adversity.