Perinatal mental health and relational outcomes of preconception childhood sexual abuse

• In Event: Physical and mental health across the lifecourse

Abstract

INTRODUCTION An estimated one in five women have experienced childhood sexual abuse (CSA) (Stoltenborgh et al., 2011). CSA is associated with increased risk of psychosocial difficulties across the lifespan (Hailes et al., 2019). The transition to parenthood may represent a time of particularly heightened vulnerability for women who have experienced CSA, when prior traumas may re-surface, triggered by the physical, emotional and interpersonal demands of pregnancy, birth and parenthood (Chamberlain et al., 2019). While there is some evidence of increased rates of perinatal depression among women with a history of CSA, this is mostly is cross-sectional (Wosu et al., 2015). Moreover, relatively little attention has been paid to contextual perinatal outcomes of CSA including social support, partner relationship, income and life stressors, despite the potential importance of the social environment in increasing or buffering risks in women with a history of CSA (Chamberlain et al., 2019).
AIM To examine associations between history of CSA and a range of perinatal mental health, relational and contextual outcomes during pregnancy and postpartum.
METHODS Data were from two population-based intergenerational cohort studies based in Victoria, Australia (VIHCS: The Victorian Intergenerational Health Cohort, est. 1992; and ATPG3: The Australian Temperament Project, Generation 3, est. 1983; combined N = 1300 mother-infant dyads). Young adult women aged 23-29 years reported on prior CSA (≤16 years), and were subsequently assessed during pregnancy and at one year postpartum for a range of perinatal mental health, relational, and contextual outcomes. Associations between history of CSA and perinatal outcomes were estimated using linear regression.
RESULTS History of CSA was associated with higher number of stressful life events, partner coercive control, and depressive symptoms; and lower income, social support, relationship quality, and parent-infant bonding. Associations were strongest for depressive symptoms (antenatal β = 0.53 [95% confidence interval 0.27,0.80]; postnatal β = 0.40 [0.17,0.62]) and social support (antenatal β = -0.51 [-0.78,-0.24], postnatal β = -0.66, [-0.89, -0.43]). Associations were evident across the two studies, and were mostly robust to adjustment for family of origin demographic characteristics.
CONCLUSIONS History of CSA was associated with diverse psychosocial outcomes during pregnancy and the first year postpartum, among adult women. Findings of this study suggest that childhood sexual abuse predicts not only increased risk of perinatal depression and early parenting difficulties, but also lower rates of contextual and relational resilience factors such as social support and partner relationship quality. These may represent priority intervention targets to buffer risks both for women with CSA and their children.

Group Authors

Intergenerational Cohort Consortium

Authors

• Elizabeth Spry, Deakin University
  Presenting Author

• Stephanie Aarsman, Murdoch Children's Research Institute
  Non-Presenting Author

• Ghazaleh Dashti, Murdoch Children's Research Institute
  Non-Presenting Author

• Christopher Greenwood, Deakin University
  Non-Presenting Author

• Primrose Letcher, University of Melbourne
  Non-Presenting Author

• Craig A Olsson, Deakin University
  Non-Presenting Author

• George C Patton, University of Melbourne
  Non-Presenting Author