title: Different labour outcomes in primiparous women that have been subjected to childhood sexual abuse or rape in adulthood: a case-control study in a clinical cohort.
abstract: OBJECTIVE
  To compare the duration and outcome of the first labour in women who have been subjected to childhood sexual abuse (CSA) and women who have been raped in adulthood (RA).
  
  
  METHODS
  Case-control study in a clinical cohort.
  
  
  METHODS
  University Hospital of North Norway.
  
  
  METHODS
  In all, 373 primiparas: 185 subjected to CSA, 47 to RA and 141 controls without a history of abuse.
  
  
  METHODS
  Data on birth outcomes were retrieved from the patient files. Information on sexual abuse was reported in consultation with specialised midwives in the mental health team. Birth outcomes were analysed by multinominal regression analysis.
  
  
  METHODS
  Vaginal births, delivery by caesarean section, operative vaginal delivery and duration of labour.
  
  
  RESULTS
  As compared with controls, the RA group showed a significantly higher risk for caesarean section (adjusted OR 9.9, 95% CI 3.4-29.4) and operative vaginal delivery (adjusted OR 12.2, 95% CI 4.4-33.7). There were no significant differences between the CSA and the control group. The RA group displayed significantly longer duration of labour in all phases as compared with the control and CSA groups.
  
  
  CONCLUSIONS
  There were major differences in the duration of labour and birth outcomes in the two abuse groups. Despite a higher proportion of obstetric risk factors at onset of labour in the CSA group, women subjected to CSA had shorter labours and less risk for caesarean section and operative vaginal deliveries than women subjected to RA. The best care for birthing women subjected to sexual abuse needs to be explored in further studies.
authors.affiliation: Department of Obstetrics and Gynaecology, University Hospital of North Norway, Tromsø, Norway.
authors.forename: H
authors.initials: H
authors.lastname: Nerum
authors.forename: L
authors.initials: L
authors.lastname: Halvorsen
authors.forename: B
authors.initials: B
authors.lastname: Straume
authors.forename: T
authors.initials: T
authors.lastname: Sørlie
authors.forename: P
authors.initials: P
authors.lastname: Øian
mesh_terms: D000293:Adolescent; D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology*; D016022:Case-Control Studies; D002648:Child; D002650:Child Abuse, Sexual; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D009664:Norway / Q000453:epidemiology; D007744:Obstetric Labor Complications / Q000453:epidemiology / Q000523:psychology*; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D011902:Rape; D012959:Socioeconomic Factors; D055815:Young Adult