Childhood Violence and Behavioral Effects Among Urban Pregnant Women

Abstract

Background:

Childhood violence has been linked to a variety of health outcomes in adulthood; however, little research has focused on the impact of childhood violence on behavior and health during pregnancy. We aimed to explore the role of experiencing childhood physical and sexual violence in health status and high-risk behaviors among young, urban pregnant women.

Methods:

Pregnant women seeking care in an urban emergency department were recruited. Information on demographics, prior and current violence, depressive symptoms, stress, substance use, and health conditions was collected, and multivariate analyses were used.

Results:

Twenty-nine percent of women reported at least one episode of childhood physical violence before the age of 16, and 14% reported at least one episode of rape during childhood. Women reporting any type of childhood violence were > twice as likely to be experiencing current violence (odds ratio [OR] 2.45, 95% confidence interval [95% CI] 1.83-2.74). Pregnant women who reported childhood physical violence without current violence had a higher odds of prior sexually transmitted diseases (STDs), confirmed cigarette use (OR 1.98, 95% CI 1.44-2.74), and depressive symptoms, adjusting for age, race, and education. The group of pregnant women reporting childhood sexual violence/rape without current violence reported significantly higher levels of depressive symptoms, stress, problem drinking, and cigarette use during pregnancy (OR 4.11, 95% CI 2.24-7.55). Women who experienced any type of childhood violence and reported current violence were > five times more likely to report depressive symptoms and have confirmed, recent cocaine use compared with women without a history of prior or current violence.

Conclusions:

These findings underscore the importance of understanding the full impact of early childhood violence on behaviors during pregnancy and provide direction for substance use and depression prevention strategies among pregnant women.

Get full access to this article

View all access options for this article.

References

Hillis

, Anda

, Dube

, Felitti

, Marchbanks

, Marks

. The association between adverse childhood experiences and adolescent pregnancy, long-term psychosocial consequences, and fetal death. Pediatrics, 2004; 113:320–327.

Hillis

, Anda

, Felitti

, Nordenberg

, Marchbanks

. Adverse childhood experiences and sexually transmitted diseases in men and women: A retrospective study. Pediatrics, 2000; 106:1–6.

Benedict

, Paine

, Brandt

, Stallings

. The association of childhood sexual abuse with depressive symptoms during pregnancy, and selected pregnancy outcomes. Child Abuse Negl, 1999; 23:659–670.

Buist

, Janson

. Childhood sexual abuse, parenting and postpartum depression- a 3-year follow-up study. Child Abuse Negl, 2001; 25:909–921.

Mamun

, Lawlor

, O'Callaghan

, Bor

, Williams

, Najman

. Does childhood sexual abuse predict young adult's BMI? A birth cohort study. Obesity, 2007; 15:2103–2110.

Bensley

, Eenwyk

, Simmons

. Self-reported childhood sexual and physical abuse and adult HIV-risk behaviors and heavy drinking. Am J Prev Med, 2000; 18:151–158.

Dietz

, Spitz

, Anda

et al. Unintended pregnancy among adult women exposed to abuse or household dysfunction during their childhood. JAMA, 1999; 14:1359–1364.

Springer

, Sheridan

, Kuo

, Carnes

. Long-term physical and mental health consequences of childhood physical abuse: Results from a large population-based sample of men and women. Child Abuse Negl, 2007; 31:517–530.

Stevens-Simon

, McAnarney

. Childhood victimization: Relationship to adolescent pregnancy outcome. Child Abuse Negl, 1994; 18:569–575.

10.

Shankaran

, Lester

, Das

et al. Impact of maternal substance use during pregnancy on childhood outcome. Semin Fetal Neonatal Med, 2007; 12,2:143–150.

11.

Cornelius

, Day

. The effects of tobacco use during and after pregnancy on exposed children. Alcohol Res Health, 2000; 24:242–249.

12.

Richter

, Richter

. Exposure to parental tobacco and alcohol use: Effects on children's health and development. Am J Orthopsychiatry, 2001; 17:182–203.

13.

Behnke

, Eyler

. The consequences of prenatal substance use for the developing fetus, newborn, and young child. Int J Addict, 1993; 28:1341–1391.

14.

Beydoun

, Saftlas

. Physical and mental health outcomes of prenatal maternal stress in human and animal studies: A review of recent evidence. Paediatr Perinat Epidemiol, 2008; 22:438–466.

15.

Hobel

, Goldstein

, Barrett

. Psychosocial stress and pregnancy outcome. Clin Obstet Gynecol, 2009; 51:333–348.

16.

Russell

. New assessment tools for drinking in pregnancy: T-ACE, TWEAK, and others. Alcohol Health Res World, 1994; 18:55–61.

17.

Scheier

, Carver

. Optimism, coping, and health: Assessment and implications of generalized outcome expectancies. Health Psychol, 1985; 4:219–230.

18.

Nelson

, McMahon

, Joffe

, Brensinger

. The effect of depressive symptoms and optimism on the risk of spontaneous abortion among innercity women. Womens Health, 2003; 12:569–576.

19.

Killingsworth-Rini

, Dunkel-Schetter

, Wadhwa

, Sandman

. Psychological adaptation and birth outcomes. Health Psychol, 1999; 18:333–351.

20.

Cohen

, Kamarck

, Mermelstein

. A global measure of perceived stress. J Health Soc Behav, 1983; 24:385–396.

21.

Stancil

. Stress and pregnancy among African American women. Paediatr Perinat Epidemiol, 2000; 14:127–135.

22.

Radloff

. The CES-D scale: A self-report depression scale for research in the general population. Appl Psychol Meas., 1977; 1:385–401.

23.

Roberts

. Relability of the CES-D scale in different ethnic contexts. Psychiatry Res, 1980; 2:125–137.

24.

Sarkar

. The impact of intimate partner violence on women's reproductive health and pregnancy outcome. J Obstet Gynaecol, 2008; 28:266–271.

25.

Heaman

. Relationships between physical abuse during pregnancy and risk factors for preterm birth among women in Manitoba. J Obstet Gynecol Neonatal Nurs, 2005; 34:721–731.

26.

Muhajarine

, D'Arcy

. Physical abuse during pregnancy: Prevalence and risk factors. Can Med Assoc J, 1999; 160:1007–1011.

27.

Alder

, Fink

, Bitzer

, Hösli

, Holzgreve

. Depression and anxiety during pregnancy: A risk factor for obstetric, fetal and neonatal outcome? A critical review of the literature. J Matern Fetal Neonatal Med, 2007; 20:189–209.