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Journal of Pediatric Psychology Advance Access originally published online on June 14, 2007
Journal of Pediatric Psychology 2007 32(10):1238-1248; doi:10.1093/jpepsy/jsm046
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© The Author 2007. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Differential Pathways to Preterm Delivery for Sexually Abused and Comparison Women

Jennie G. Noll, PhD1, Jay Schulkin, PhD2, Penelope K. Trickett, PhD3, Elizabeth J. Susman, PhD4, Lesley Breech, MD1 and Frank W. Putnam, MD1

1Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, 45229-3039, 2Department of Physiology, Georgetown University, Washington DC, 20057, 3University of Southern California, School of Social Work, Los Angeles, CA 90089, and 4Department of Human Development, The Pennsylvania State University, University Park, PA, 16802, USA

All correspondence concerning this article should be addressed to Jennie G. Noll PhD, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, Division of Behavioral Medicine and Clinical Psychology, 3333 Brunet Avenue MLC 3015, Cincinnati, OH 45229-3039, USA. E-mail: jennie.noll{at}cchmc.org.


  Abstract

Objective Two distinct conditions, Hypothalamic Pituitary Adrenal (HPA) axis disruptions and maternal alcohol use, have been linked to preterm delivery. These conditions have also been cited as potential sequelae of childhood abuse. Studies have linked childhood abuse to increased rates of preterm delivery but mechanisms explaining this association are unclear. Methods This prospective study compared preterm birth rates across offspring born to mothers who were sexually abused in childhood (OA; N = 67) and offspring born to nonabused comparison mothers (OC; N = 56). Results Preterm delivery rates were higher for the OA group (Odds = 2.80 ± 1.44, p < .05). Maternal prenatal alcohol use mediated this relationship, but HPA axis functioning did not. Heightened maternal cortisol was significantly related to preterm status, but only for the OC group. Conclusions Results support the hypothesis that childhood abuse is a risk-factor for preterm delivery, however pathways are likely different for women with and without histories of sexual abuse.

Key words: childhood sexual abuse; cortisol; HPA axis; prenatal alcohol use; preterm delivery.

Received November 29, 2006; revision received April 16, 2007; accepted May 8, 2007


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