title: Childhood abuse is associated with stress-related sleep disturbance and poor sleep quality in pregnancy.
abstract: OBJECTIVE
  Childhood abuse is associated with increased risks of adult psychiatric disorders and physical health conditions. Mounting evidence documents associations of childhood abuse with sleep disturbances in adulthood. However, to date, no study has evaluated associations of childhood abuse and sleep disturbances among pregnant women.
  
  
  METHODS
  This cross-sectional study included 634 pregnant Peruvian women. To collect information regarding socio-demographic characteristics, history of childhood abuse, and complaints of sleep disturbances, face-to-face interviews were conducted with women in early pregnancy. Ford Insomnia Response to Stress Test (FIRST-S) and the Pittsburgh Sleep Quality Index (PSQI-S), translated from English to Spanish, were used to assess stress-related sleep disturbance and sleep quality, respectively. Logistic regression was used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (95% CIs).
  
  
  RESULTS
  Women who experienced any childhood abuse had a 1.65-fold increased odds of stress-related sleep disturbance (aOR = 1.65; 95% CI: 1.15-2.38) and 2.11-fold increased odds of poor sleep quality during early pregnancy (aOR = 2.11; 95% CI: 1.35-3.30) as compared with women who reported no abuse. Women who reported both physical and sexual abuse during childhood were more than twice as likely to suffer from stress-related sleep disturbance (aOR = 2.26; 95% CI: 1.44-3.53) and poor sleep quality (aOR = 2.43; 95% CI: 1.45-4.09) in comparison to women who reported no childhood abuse.
  
  
  CONCLUSIONS
  A history of childhood abuse is associated with increased odds of stress-related sleep disturbance and poor sleep quality during pregnancy. These findings, if replicated, should be used to inform the development of trauma-informed care for such sleep disturbances induced by childhood trauma.
authors.affiliation: Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA. Electronic address: bgelaye@hsph.harvard.edu.
authors.forename: Bizu
authors.initials: B
authors.lastname: Gelaye
authors.affiliation: Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
authors.forename: Sandhya
authors.initials: S
authors.lastname: Kajeepeta
authors.affiliation: Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
authors.forename: Qiu-Yue
authors.initials: QY
authors.lastname: Zhong
authors.affiliation: Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Christina P C
authors.initials: CP
authors.lastname: Borba
authors.affiliation: Department of Medicine, Cayetano Heredia Peruvian University, Lima, Peru.
authors.forename: Marta B
authors.initials: MB
authors.lastname: Rondon
authors.affiliation: Universidad Peruana de Ciencias Aplicadas, Lima, Peru; Asociación Civil PROESA, Lima, Peru.
authors.forename: Sixto E
authors.initials: SE
authors.lastname: Sánchez
authors.affiliation: Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: David C
authors.initials: DC
authors.lastname: Henderson
authors.affiliation: Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Williams
mesh_terms: D000293:Adolescent; D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D000066511:Intimate Partner Violence / Q000523:psychology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology*; D012893:Sleep Wake Disorders / Q000150:complications* / Q000209:etiology; D013315:Stress, Psychological / Q000150:complications*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Childhood abuse; Life course; Pregnancy; Sleep disturbance; Stress