Alexa A Freedman1, Alison L Cammack2, Jeff R Temple3, Robert M Silver4, Donald J Dudley5, Barbara J Stoll6, Michael W Varner4, George R Saade3, Deborah Conway7, Robert L Goldenberg8, Carol J Hogue2. 1. Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA. Electronic address: Alexa.freedman@emory.edu. 2. Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA. 3. Department of Obstetrics and Gynecology, University of Texas Medical Branch at Galveston, University of Texas, Galveston. 4. Department of Obstetrics and Gynecology, School of Medicine, University of Utah, Salt Lake City. 5. Department of Obstetrics and Gynecology, School of Medicine, University of Virginia, Charlottesville. 6. McGovern Medical School, University of Texas Health Science Center, Houston. 7. Department of Obstetrics and Gynecology, University of Texas Health Science Center at San Antonio, San Antonio. 8. Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, NY.
Abstract
PURPOSE: To determine the association between maternal exposure to childhood maltreatment (CM) and risk of stillbirth (fetal death at or after 20 weeks' gestation). METHODS: Population-based case-control study from the Stillbirth Collaborative Research Network (SCRN) conducted in 2006-2008, and the follow-up study, SCRN-Outcomes after Study Index Stillbirth (SCRN-OASIS), conducted in 2009 in the United States. Cases (n = 133) included women who experienced a stillbirth, excluding stillbirths attributed to genetic/structural or umbilical cord abnormalities and intrapartum stillbirths. Controls (n = 500) included women delivering a healthy term live birth (excluding births less than 37 weeks gestation, neonatal intensive care unit admission, or death). CM exposure was measured using the Childhood Trauma Questionnaire, administered during the SCRN-OASIS study. Dichotomized scores for five subscales of CM (physical abuse, physical neglect, emotional abuse, emotional neglect, and sexual abuse) and an overall measure of CM exposure were analyzed using logistic regression. RESULTS: Generally, there was no association between CM and stillbirth, except for the emotional neglect subscale (OR: 1.93; 95% CI: 1.17, 3.19). CONCLUSIONS: Childhood neglect is understudied in comparison to abuse and should be included in the future studies of associations between CM and pregnancy outcomes, including stillbirth.
PURPOSE: To determine the association between maternal exposure to childhood maltreatment (CM) and risk of stillbirth (fetal death at or after 20 weeks' gestation). METHODS: Population-based case-control study from the Stillbirth Collaborative Research Network (SCRN) conducted in 2006-2008, and the follow-up study, SCRN-Outcomes after Study Index Stillbirth (SCRN-OASIS), conducted in 2009 in the United States. Cases (n = 133) included women who experienced a stillbirth, excluding stillbirths attributed to genetic/structural or umbilical cord abnormalities and intrapartum stillbirths. Controls (n = 500) included women delivering a healthy term live birth (excluding births less than 37 weeks gestation, neonatal intensive care unit admission, or death). CM exposure was measured using the Childhood Trauma Questionnaire, administered during the SCRN-OASIS study. Dichotomized scores for five subscales of CM (physical abuse, physical neglect, emotional abuse, emotional neglect, and sexual abuse) and an overall measure of CM exposure were analyzed using logistic regression. RESULTS: Generally, there was no association between CM and stillbirth, except for the emotional neglect subscale (OR: 1.93; 95% CI: 1.17, 3.19). CONCLUSIONS: Childhood neglect is understudied in comparison to abuse and should be included in the future studies of associations between CM and pregnancy outcomes, including stillbirth.
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Authors: Vicki Flenady; Aleena M Wojcieszek; Philippa Middleton; David Ellwood; Jan Jaap Erwich; Michael Coory; T Yee Khong; Robert M Silver; Gordon C S Smith; Frances M Boyle; Joy E Lawn; Hannah Blencowe; Susannah Hopkins Leisher; Mechthild M Gross; Dell Horey; Lynn Farrales; Frank Bloomfield; Lesley McCowan; Stephanie J Brown; K S Joseph; Jennifer Zeitlin; Hanna E Reinebrant; Joanne Cacciatore; Claudia Ravaldi; Alfredo Vannacci; Jillian Cassidy; Paul Cassidy; Cindy Farquhar; Euan Wallace; Dimitrios Siassakos; Alexander E P Heazell; Claire Storey; Lynn Sadler; Scott Petersen; J Frederik Frøen; Robert L Goldenberg Journal: Lancet Date: 2016-01-19 Impact factor: 79.321