The association of childhood sexual abuse with depressive symptoms during pregnancy, and selected pregnancy outcomes

Objectives: The objectives were: (1) to investigate the association during pregnancy of sexual abuse before the age of 18 on depressive symptomatology in pregnancy, controlling for the presence of negative life events and cha llenges; and (2) to investigate the association of selected pregnancy outco mes (maternal labor and delivery factors, infant birth weight and gestation al age) with sexual abuse before age 18. Methods: Three hundred fifty-seven primiparous women aged 18 years and olde r were interviewed between 28-32 weeks gestation with reference to current functioning and past history (Objective 1). Medical record information was abstracted after delivery for pregnancy, labor and delivery factors, and pr egnancy outcomes (Objective 2). Results: Thirty-seven percent of the women reported past sexual abuse. Prev alence was not associated with ethnic background, educational level, or hos pital payment source. Previously sexually-abused pregnant women reported si gnificantly higher levels of depressive symptomatology, negative life event s, and physical and verbal abuse before and during pregnancy. There were no significant associations found between past sexual abuse and labor or deli very variables or newborn outcomes. Conclusions: Previously sexually-abused pregnant women reported a wider con stellation of past and current functioning problems than nonabused women al though past sexual abuse was not associated with pregnancy outcome. Prenata l care provides a unique opportunity to evaluate the impact of life history and current life events during pregnancy, and to develop a coordinated int ervention plan. (C) 1999 Elsevier Science Ltd.