Pregnancy complications in women with childhood sexual abuse experiences.
OBJECTIVE
Childhood sexual abuse (CSA) has an estimated prevalence of 20% and has a constantly growing list of known long-term consequences on physical as well as psychological health which may also influence obstetrical care attributed to it. However, scientific data on the association of CSA and pregnancy are sparse. Therefore, the study investigated pregnancy complications in women exposed to CSA.


METHODS
The study was designed as a cohort study comparing 85 women exposed to CSA with 170 matched unexposed women. CSA was identified by interview using modified questions from Wyatt [Child Abuse Negl 9 (1985) 507-519]. Data on pregnancy complications were collected by questionnaire and based on entries in a booklet (Mutterpass) in which all relevant data on pregnancy are documented at each prenatal consultation for any women attending prenatal care in Germany. Statistical analysis was performed with chi square, Fisher's Exact Test, and multiple logistic regression analysis to control the association between CSA and pregnancy complications for confounders significant in univariate analysis, i.e., physical abuse, other adverse experiences during childhood, abuse during pregnancy, substance abuse, and occupation.


RESULTS
Women exposed to CSA were significantly more often hospitalized during pregnancy (41.2%/19.4%; OR 2.91, CI 1.64-5.17). They presented more often complications such as premature contractions (38.8%/20%; OR 2.54 CI 1.43-4.51), cervical insufficiency (25.9%/9.4%; OR 3.36, CI 1.65-6.82), and premature birth (18.8%/8.2%; OR 2.58, CI 1.19-5.59).


CONCLUSIONS
Therefore, health care providers should adapt prenatal care to the specific needs of women exposed to CSA.
Department of Gynecology and Obstetrics, University Hospital Zurich, Zurich, Switzerland. Brigitte.Leeners@usz.ch
Brigitte
B
Leeners
Ruth
R
Stiller
Emina
E
Block
Gisela
G
Görres
Werner
W
Rath
D000328:Adult; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D002648:Child; D002650:Child Abuse, Sexual / Q000523:psychology* / Q000706:statistics & numerical data*; D015331:Cohort Studies; D005260:Female; D005858:Germany / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D007752:Obstetric Labor, Premature / Q000453:epidemiology / Q000523:psychology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D047928:Premature Birth / Q000453:epidemiology / Q000523:psychology; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires; D002581:Uterine Cervical Incompetence / Q000453:epidemiology / Q000523:psychology; D014590:Uterine Contraction / Q000523:psychology