Childhood Abuse and PTSD: The Impact on Preterm Delivery and Spontaneous Abortion

童年虐待和创伤后应激障碍：对早产和自然流产的影响

• 批准号: 7770523
• 负责人: Sabrina Charise Selk
• 金额: $ 2.61万
• 依托单位: HARVARD SCHOOL OF PUBLIC HEALTH
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-30 至 2010-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7770523
• 关键词: Childhood; Abuse; PTSD; Impact; Preterm

DESCRIPTION (provided by applicant): To date, there is insufficient empirical evidence exploring the long term health consequences of childhood exposure to trauma and violence. Although immediate consequences subsequent to the trauma, and mental health correlates have been well studied, health consequences related to either alteration in HPA functioning or consequences of negative life style behaviors, are not well understood. Although researchers have begun to look at reproductive outcomes, such as preterm delivery, with childhood trauma, the research that has been done to date has often failed to look at multiple forms of abuse, and has failed to consider the role of post- traumatic stress disorder (PTSD) as it relates to childhood trauma and health. The purpose of this dissertation is to investigate the long term reproductive health outcomes of children who have been exposed to childhood maltreatment. In order to examine this relationship, an observational dataset of a large cohort of female nurses, Nurses Health Study II, will be explored to see whether a relationship exists between various types of childhood maltreatment, including physical, sexual and emotional abuse, and pregnancy outcomes, such as, preterm delivery and second trimester pregnancy loss. Furthermore, the relationship of psychopathology to reproductive outcomes will be explored, by assessing the relationship between post-traumatic stress disorder (PTSD) symptoms with these pregnancy outcomes. Utilizing a life course model of health linking childhood exposures to adult health outcomes, this research will help explore the potential role of childhood trauma as an exposure with repercussions that last far beyond the immediate period of childhood and adolescence. There is a persistent need for research to provide empirical evidence with regards to the long term health impacts related to childhood maltreatment. This research can be used to support the promotion of high quality care to meet the needs of children who have suffered maltreatment, as well as increasing awareness of the need for prevention services that will be of benefit not only to children, but may also serve to decrease the burden of disease across the life course. PUBLIC HEALTH RELEVANCE: This research will investigate whether childhood abuse increases risk for poor pregnancy outcomes, and the possible role of mental health and health behaviors in the development of these conditions. This research would be important to increasing awareness among researchers, clinicians, and policy makers as to the long term consequences of childhood abuse, as well as beginning to address how these experiences might lead to poor health.

描述（由申请人提供）：迄今为止，没有足够的经验证据来探讨童年时期遭受创伤和暴力对健康的长期影响。虽然创伤后的直接后果和心理健康相关性已经得到了很好的研究，但与下丘脑功能改变或消极生活方式行为的后果相关的健康后果尚未得到很好的理解。尽管研究人员已经开始研究与童年创伤有关的生育结果，如早产，但迄今为止所做的研究往往未能研究多种形式的虐待，也未能考虑创伤后应激障碍（PTSD）在童年创伤和健康方面的作用。本论文的目的是调查儿童遭受虐待的长期生殖健康结果。为了检验这种关系，将对一大批女护士的观察性数据集“护士健康研究II”进行研究，以了解各种类型的儿童虐待（包括身体、性和情感虐待）与妊娠结局（如早产和妊娠中期流产）之间是否存在关系。此外，通过评估创伤后应激障碍（PTSD）症状与这些妊娠结局之间的关系，将探讨精神病理学与生殖结局的关系。利用将童年暴露与成人健康结果联系起来的生命历程模型，本研究将有助于探索童年创伤作为一种暴露的潜在作用，其影响远远超出了童年和青春期的直接时期。一直需要进行研究，以提供与儿童虐待有关的长期健康影响方面的经验证据。这项研究可用于支持促进高质量的护理，以满足遭受虐待的儿童的需要，并提高对预防服务需求的认识，这不仅有利于儿童，而且可能有助于减轻整个生命过程中的疾病负担。