title: Adverse childhood experiences influence development of pain during pregnancy.
abstract: OBJECTIVE
  To investigate the association between adverse childhood experiences (ACE) and pain with onset during pregnancy.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Eighteen antenatal clinics in southern Mid-Sweden.
  
  
  METHODS
  Of 293 women invited to participate, 232 (79%) women agreed to participate in early pregnancy and were assessed in late pregnancy.
  
  
  METHODS
  Questionnaires were distributed in early and late pregnancy. The questionnaires sought information on socio-demography, ACE, pain location by pain drawing and pain intensity by visual analogue scales. Distribution of pain was coded in 41 predetermined areas.
  
  
  METHODS
  Pain in third trimester with onset during present pregnancy: intensity, location and number of pain locations.
  
  
  RESULTS
  In late pregnancy, 62% of the women reported any ACE and 72% reported any pain location with onset during the present pregnancy. Among women reporting any ACE the median pain intensity was higher compared with women without such an experience (p = 0.01). The accumulated ACE displayed a positive association with the number of reported pain locations in late pregnancy (rs = 0.19, p = 0.02). This association remained significant after adjusting for background factors in multiple regression analysis (p = 0.01). When ACE was dichotomized the prevalence of pain did not differ between women with and without ACE. The subgroup of women reporting physical abuse as a child reported a higher prevalence of sacral and pelvic pain (p = 0.0003 and p = 0.02, respectively).
  
  
  CONCLUSIONS
  Adverse childhood experiences were associated with higher pain intensities and larger pain distributions in late pregnancy, which are risk factors for transition to chronic pain postpartum.
authors.affiliation: Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Drevin
authors.affiliation: Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
authors.forename: Jenny
authors.initials: J
authors.lastname: Stern
authors.affiliation: Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.|Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden.
authors.forename: Eva-Maria
authors.initials: EM
authors.lastname: Annerbäck
authors.affiliation: Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
authors.forename: Magnus
authors.initials: M
authors.lastname: Peterson
authors.affiliation: Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
authors.forename: Stephen
authors.initials: S
authors.lastname: Butler
authors.affiliation: Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
authors.forename: Tanja
authors.initials: T
authors.lastname: Tydén
authors.affiliation: National Centre for Knowledge on Men's Violence against Women, Uppsala University, Akademiska Hospital, Uppsala, Sweden.
authors.forename: Anna
authors.initials: A
authors.lastname: Berglund
authors.affiliation: Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
authors.forename: Margareta
authors.initials: M
authors.lastname: Larsson
authors.affiliation: Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
authors.forename: Per
authors.initials: P
authors.lastname: Kristiansson
mesh_terms: D000328:Adult; D002648:Child; D002649:Child Abuse / Q000523:psychology / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D010146:Pain / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D010147:Pain Measurement; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D011261:Pregnancy Trimester, First; D011263:Pregnancy Trimester, Third; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013548:Sweden
keywords: adverse childhood experiences; antenatal care; childhood physical abuse; pain; pregnancy