Childhood abuse and unplanned pregnancies: a cross‐sectional study of women in the Norwegian Mother and Child Cohort Study

Abstract

Objective To study if childhood emotional, physical and sexual abuse are determinants for having an unplanned pregnancy, if the categories of abuse interact, and if a potential bias due to the selection of the participants (collider stratification bias) could explain the effect of childhood abuse. Design A cross‐sectional study. Setting The study is based on the Norwegian Mother and Child Cohort Study (MoBa) and uses data from the Medical Birth Registry of Norway. Sample Women participating in the MoBa for the first time, ≥18 years of age who responded to questions regarding childhood abuse and pregnancy planning (n = 76 197). Methods Data were collected using questionnaires. We conducted analyses using modified Poisson regressions and the relative excess risks due to interaction (RERI). Sensitivity analyses were performed. Main outcome measure An unplanned pregnancy (yes/no). Results Exposure to childhood emotional (adjusted relative risk [RR] 1.14, 95% CI 1.10–1.19), physical (adjusted RR 1.11, 95% CI 1.04–1.18) and sexual (adjusted RR 1.20, 95% CI 1.14–1.27) abuse increased the risk of having an unplanned pregnancy. The effects could not be explained by the collider stratification bias. The different combinations of categories of abuse did not show any interaction effects. Conclusions Childhood emotional, physical and sexual abuses separately increase the risk of having an unplanned pregnancy. The results indicate that victims of childhood abuse are in greater need of support to achieve their reproductive goals. Tweetable abstract Childhood abuse increases the risk of having an unplanned pregnancy. #reproductivehealth #epitwitter.

Adverse childhood experiences and repeated induced abortion in Aquitaine region, France: a cross-sectional survey

“…This support allows the caregiver to become the enlightened witness, described by the author Alice Miller known for her essays about consequences of childhood violence on adulthood [38], again mentioned in Felitti and Anda's conclusions [6]. It is an opportunity offered to this woman, this couple, to restore this negatively affected self-esteem (during the first years of life) -with the time needed to learn again.…”

“…Many studies show otherwise that being or having been the victim of violence, particularly sexual violence, has implications in the sexual behaviour and the handling of contraception, which increases the risk of an unwanted pregnancy [5,6].…”

Prevalence of self‐reported emotional, physical, and sexual abuse and association with fear of childbirth in pregnant women with epilepsy: The Norwegian Mother, Father, and Child Cohort Study

“…During gestational Week 30, the women answered four questions regarding emotional, physical, and sexual abuse 11,23–25 that were modified from the validated NorVold Abuse Questionnaire 26 : “Has someone over a long period of time systematically tried to subdue, degrade, or humiliate you?” “Has someone threatened to hurt you or someone close to you?” “Have you been subjected to physical abuse?” “Have you been pressured to sexual activities?” The response options were “No, never,” “Yes, as a child,” “Yes, as an adult,” and “Yes, during the past year.” It was possible to choose more than one option. We grouped positive answers into three dichotomous variables by abuse subcategory: emotional abuse (first two questions), physical abuse (third question), and sexual abuse (fourth question).…”

Description, prediction and causation: Methodological challenges of studying child and adolescent development

“…Given the major implications of controlling for a collider and its prominence in the literature in other disciplines such as epidemiology, it is somewhat surprising that this phenomenon is not very well known in developmental research. One of the few exceptions is the study by Drevin et al (2020) , who study the causal effect of childhood abuse on unplanned pregnancies in the large Norwegian Mother and Child Cohort Study (MoBa). They present a DAG (Figure 1 in their paper), which shows that the decision to have an abortion is influenced by both childhood abuse (the putative cause), and whether it was a planned or unplanned pregnancy (the outcome of interest).…”

“…They present a DAG (Figure 1 in their paper), which shows that the decision to have an abortion is influenced by both childhood abuse (the putative cause), and whether it was a planned or unplanned pregnancy (the outcome of interest). Since only women who did not have an abortion were selected for this study, this implies there was conditioning on (a descendent of) a collider, which will result in collider stratification bias ( Drevin et al, 2020 ). For further elaborations, see Austin et al (2019) , who systematically discuss DAGs in the study of child maltreatment.…”