Childhood physical and sexual abuse experiences associated with post-traumatic stress disorder among pregnant women

Ann Epidemiol. 2017 Nov;27(11):716-723.e1. doi: 10.1016/j.annepidem.2017.09.012. Epub 2017 Oct 13.

Abstract

Purpose: We sought to evaluate the extent to which childhood physical and/or sexual abuse history is associated with post-traumatic stress disorder (PTSD) during early pregnancy and to explore the extent to which the childhood abuse-PTSD association is mediated through, or modified by, adult experiences of intimate partner violence (IPV).

Methods: In-person interviews collected information regarding history of childhood abuse and IPV from 2,928 women aged 18-49 years old prior to 16 weeks of gestation. PTSD was assessed using the PTSD Checklist-Civilian Version. Multivariate logistic regressions were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs).

Results: Compared to women with no childhood abuse, the odds of PTSD were increased 4.31-fold for those who reported physical abuse only (95% CI, 2.18-8.49), 5.33-fold for sexual abuse only (95% CI, 2.38-11.98), and 8.03-fold for those who reported physical and sexual abuse (95% CI, 4.10-15.74). Mediation analysis showed 13% of the childhood abuse-PTSD association was mediated by IPV. Furthermore, high odds of PTSD were noted among women with histories of childhood abuse and IPV compared with women who were not exposed to either (OR = 20.20; 95% CI, 8.18-49.85).

Conclusions: Childhood abuse is associated with increased odds of PTSD during early pregnancy. The odds of PTSD were particularly elevated among women with a history of childhood abuse and IPV. Efforts should be made to prevent childhood abuse and mitigate its effects on women's mental health.

Keywords: Childhood abuse; Early pregnancy; PTSD; Peru.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Adult Survivors of Child Abuse / psychology*
  • Adult Survivors of Child Abuse / statistics & numerical data
  • Female
  • Humans
  • Intimate Partner Violence
  • Middle Aged
  • Peru / epidemiology
  • Population Surveillance
  • Pregnancy
  • Pregnant People / psychology*
  • Prevalence
  • Risk Factors
  • Sex Offenses / psychology*
  • Sex Offenses / statistics & numerical data
  • Socioeconomic Factors
  • Stress Disorders, Post-Traumatic / complications
  • Stress Disorders, Post-Traumatic / epidemiology
  • Stress Disorders, Post-Traumatic / psychology*