Project 2: Maternal history of childhood sexual abuse and adverse perinatal outcomes: Harnessing novel ecological methods to understand mechanisms

点击翻译按钮获取中文摘要

PROJECT SUMMAY / ABSTRACT 1 in 5 women in obstetric care experienced sexual abuse in childhood. Women with histories of child sexual abuse are 2x more likely to experience hypertensive disorders of pregnancy (HDP), a leading cause of maternal and fetal morbidity and mortality in the United States. $2.18 billion is spent annually on treatment of affected mothers and infants in the year after delivery. In addition, HDP increases lifetime cardiac disease risk by 2-4X and is considered an independent, gender-specific cardiovascular risk factor by the American Heart Association. Identification of treatment targets for the prevention of HDP holds tremendous promise in the prevention of cardiovascular diseases later in life. Maternal history of child sexual abuse is hypothesized to increase risk for HDP through stress-induced activation of the autonomic nervous system. Routine prenatal experiences, including prenatal care appointments, pregnancy symptoms, and fetal movements, may be a significant source of stress for women with child sexual abuse histories as these experiences can serve as disturbing reminders of previous sexual abuse. Therefore, perceptions of bodily sensations (i.e., interoception), may trigger autonomic stress responses and increase risk for HDP among women with child sexual abuse histories. Conversely, consistent with the stress buffering model, supportive social context may interrupt interoceptive perceptions and decrease autonomic activation for women with child sexual abuse histories. The objective of the proposed study is to characterize interoceptive and autonomic responses to prenatal experiences as pathways to HDP in women with and without CSA histories, and to examine the moderating role of social context. We will use a novel methodological approach by integrating EMA, ambulatory biometric wearable technology, and electronically activated recorder (EAR) methods to rigorously assess daily interoceptive and autonomic responses to prenatal experiences across gestation. Results from this area of research are expected to have an important positive impact on the field because new knowledge may be used to select meaningful targets for interventions to regulate blood pressure and the development of HDP, and to prevent cardiovascular illness later in life.