Influence of childhood sexual abuse on pregnancy, delivery, and the early postpartum period in adult women

Leeners, Brigitte; Richter‐Appelt, Hertha; Imthurn, Bruno; Rath, Werner

doi:10.1016/j.jpsychores.2005.11.006

Cited by 113 publications

(134 citation statements)

References 89 publications

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“…Consequences of abusive childhood experiences are associated with an increased risk for pregnancy complications, and may therefore, have a negative impact on pregnancy outcome [16,17,22]. The fact that at least one out of five women has been exposed to sexual abuse, and 29-78% to physical abuse during childhood support the relevance of such experiences in prenatal care [15,16,18].…”

Section: Introductionmentioning

confidence: 99%

“…The fact that at least one out of five women has been exposed to sexual abuse, and 29-78% to physical abuse during childhood support the relevance of such experiences in prenatal care [15,16,18]. In addition to abuse, other adverse childhood experiences (ACE), for example, burdensome life events/family structures, are likely to impair adult women's health [20,26].…”

Section: Introductionmentioning

confidence: 99%

“…During pregnancy, they compromise not only the women's, but also the infant's health [11,16]. Alcohol, for example, is a potent teratogen and its use during pregnancy is associated with fetal growth restriction, low birth weight, congenital anomalies, and perinatal death [22].…”

Section: Introductionmentioning

confidence: 99%

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Risk factors for unfavorable pregnancy outcome in women with adverse childhood experiences

Leeners

Rath

Block³

et al. 2013

Journal of Perinatal Medicine

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Aims: To explore the association between childhood sexual abuse (CSA), physical abuse, as well as other adverse childhood experiences (ACE), and different obstetrical risk factors/behaviors. Methods: In this cohort study, obstetrical risk factors and perinatal outcome in 85 women exposed to CSA were compared to 170 matched unexposed women. CSA, physical abuse, and ACE were explored by face-to-face interviews and by questionnaire. Data on perinatal outcome were extracted from medical charts. Fisher's exact, χ 2 -test, and multiple logistic regression were used for statistical analysis. Results: During pregnancy women with CSA experiences were significantly more often smoking (31.7%/9.4%; P < 0.0001), had partners abusing drugs (10.6%/1.2%; P < 0.0005), experienced physical (16.5%/0; P < 0.0001), sexual (12.9%/0; P < 0.0001), and emotional abuse (44.7%/1.7%; P < 0.0001), reported depression (24.7%/1.8%; P < 0.0001), and suicidal ideation (10.6%/0; P < 0.0001) than women without CSA experiences. Differences in risk factors were more often correlated with physical than with sexual abuse during childhood. The probability for premature delivery was associated with CSA, physical abuse and ACE as well as with several of the risk factors investigated. Conclusion: Women with CSA, physical, and ACE present with a variety of abuse-associated obstetrical risk factors and an increased risk for premature delivery. Therefore, all types of abusive and other ACE should be considered in prenatal care.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Risk factors for unfavorable pregnancy outcome in women with adverse childhood experiences

Leeners

Rath

Block³

et al. 2013

Journal of Perinatal Medicine

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“…Just recently, international surveys have extended the models for the understanding of factors related to the access and quality of women's adherence to the services, including hostile family environment as a potential obstacle to care provided during gestation; some of them have suggested that women who were victims of family violence used less the healthcare services and delayed prenatal care. 1,8,15,25 Nevertheless, this gap in the knowledge of the process remains, considering that the existing research is predominantly conducted in developed countries and explores the theme in an insuffi cient way. Most studies use inadequate methods to identify violence during gestation and do not appraise the effect of intimate partner violence conditioned to the possible confounding factors.…”

Section: Introductionmentioning

confidence: 99%

Violência física entre parceiros íntimos na gestação como fator de risco para a má qualidade do pré-natal

2010

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OBJECTIVE:To evaluate physical intimate partner violence during gestation as an independent risk factor for low quality of prenatal care. METHODS:A cross-sectional study was carried out at three public maternity wards of the municipality of Rio de Janeiro (Southeastern Brazil). The 528 puerperal women included in the study were selected by simple random sampling from all babies born at term in 2000. Prenatal care information was collected through the pregnant woman's card and face-to-face interviews. The Kotelchuck index was employed to assess the quality of prenatal care. In order to identify violence situations, the Brazilian version of the instrument Revised Confl ict Tactics Scales was used. Non-conditional logistic regression was used to assess the effect of exposure, after controlling for confounding variables. RESULTS:Even after adjustment for socioeconomic, demographic, reproductive, and couple's lifestyle variables, physical intimate partner violence during gestation remained associated with low quality of prenatal care. Women exposed to physical violence during gestation had 2.2 times more chance of presenting inadequate prenatal care compared to those without history of physical violence. CONCLUSIONS:These fi ndings point to the need of identifying family confl ict situations since the beginning of prenatal care in order to address the issue and enable higher adherence to follow-up among victimized pregnant women. DESCRIPTORS:Pregnancy. Battered Women. Spouse Abuse. Violence Against Women. Prenatal Care. Domestic Violence.

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“…Based on data from the USA, Australia, Canada and European countries such as the UK, Germany and Sweden, the prevalence of childhood sexual abuse (CSA) experiences is around 20 % in unselected women and 13 % in parous women [13,17,19,32] . Because abuse experiences often remain undisclosed, the true prevalence of CSA is probably even higher.…”

Section: Introductionmentioning

confidence: 99%

Prenatal care in adult women exposed to childhood sexual abuse

Leeners

Stiller

Block³

et al. 2012

Journal of Perinatal Medicine

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Aims: Several case reports show a negative impact of childhood sexual abuse (CSA) on prenatal care. The study aimed to systematically investigate this association in a larger study group. Methods: CSA was investigated by face-to-face interviews and by a modified questionnaire developed by Wyatt. All study participants completed a self-administered questionnaire designed to investigate the consequences of CSA on prenatal care during adulthood. Data from 85 women after CSA were compared to those of 170 matched women without such experiences. Results: Women exposed to CSA had fewer than five prenatal consultations more often than unexposed women (26 % /7 % ; P < 0.0001). Of the 85 women with a positive history for CSA, 9.4 % had been asked for such antecedents, 36.5 % had intense memories on original abuse situations during pregnancy, 56.6 % mentioned specific consequences of CSA on prenatal care and 61.2 % were satisfied with obstetrical support. Exposed women (62.4 % ) felt significantly less prepared for labor than unexposed women (75.9 % ) (P < 0.0001). Conclusions: CSA experiences are associated with impaired prenatal care. These results underscore the compelling need to improve prenatal care in women exposed to CSA through better education of obstetricians regarding the effects of CSA and in their ability to provide empathetic professional support.

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Influence of childhood sexual abuse on pregnancy, delivery, and the early postpartum period in adult women

Cited by 113 publications

References 89 publications

Risk factors for unfavorable pregnancy outcome in women with adverse childhood experiences

Risk factors for unfavorable pregnancy outcome in women with adverse childhood experiences

Violência física entre parceiros íntimos na gestação como fator de risco para a má qualidade do pré-natal

Prenatal care in adult women exposed to childhood sexual abuse

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