title: Risk factors for unfavorable pregnancy outcome in women with adverse childhood experiences.
abstract: OBJECTIVE
  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, χ2-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.
  
  
  CONCLUSIONS
  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.
authors: Brigitte
authors: B
authors: Leeners
authors: Werner
authors: W
authors: Rath
authors: Emina
authors: E
authors: Block
authors: Gisela
authors: G
authors: Görres
authors: Sibil
authors: S
authors: Tschudin
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002648:Child; D002650:Child Abuse, Sexual / Q000523:psychology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D012307:Risk Factors; D055815:Young Adult