Childhood trauma may increase risk of pregnancy complications

The risk of pregnancy complications, high blood pressure, pregnancy-related diabetes, depression/anxiety and giving birth to underweight and/or premature babies may be significantly higher for women who experience childhood trauma, such as abuse, emotional neglect and exposure to domestic violence.

The finding is based on pooled data analysis of the available evidence, published in the open-access journal BMJ Open. The researchers reviewed 32 relevant studies, published between 1994 and 2022. Three out of four were long-term (cohort) studies, with the remainder observational or comparative (case-control) studies.

Most (19) were carried out in the USA; the rest were from Canada (three), Europe (six) and other regions (four). Study participants ranged in number from 48 to 11,556. Pooled data analysis of 21 studies showed that, overall, women who had experienced some form of childhood trauma were 37% more likely to have pregnancy complications than those who hadn’t. They were also 31% more likely to give birth to underweight or premature babies.

Further in-depth analysis showed that childhood trauma was associated with a 39% heightened risk of pregnancy-related diabetes, a 59% heightened risk of antenatal depression, a 27% heightened risk of giving birth to an underweight baby and a 41% heightened risk of preterm delivery.

There could be several direct and indirect explanations for the findings, the researchers suggested. Childhood trauma might alter regulation of stress signalling pathways and immune system function; it might also change brain structure and function; or it might speed up cellular aging.

Previously published research suggests that it’s also associated with a greater likelihood of risky behaviours in adulthood, including substance misuse, physical inactivity and poor diet, all of which may influence the risk of pregnancy complications and outcomes.

The researchers acknowledged that most of the included studies were from high-income western countries and so the findings may not be generalisable elsewhere, nor were they able to assess the potential impact of different types of childhood trauma.

Nevertheless, they concluded, “The results suggest that exposure to [childhood trauma] increases the risk of pregnancy complications and adverse pregnancy outcomes. The identification of women exposed to [these experiences] and personalising their care may provide opportunities to improve maternal and child mental and physical health.”

They emphasised, “Beyond screening for [childhood trauma], our findings emphasise the importance of preventing [these events] in children to reduce immediate impacts as well as intergenerational transmission.”

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