ArticlesChildhood sexual abuse and preterm labor in adulthood: an endocrinological hypothesis
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Intimate partner violence and pregnancy
Research suggests that there is an association between domestic violence and low birth weight infants, preterm labor, and premature delivery.2 Intimate partner violence during the perinatal period may adversely affect pregnancy outcome directly and indirectly. Some of the pregnancy effects may result from the psychosocial stress of the abuse.6 One study demonstrated that abused women who had recently experienced extremely stressful events, including domestic violence, suffered spontaneous
Definition and health consequences of childhood sexual abuse
Childhood sexual abuse may be defined as any activity that engages a child in sexual activities that are developmentally inappropriate, with or without threatened or actual violence or injury. Sexual abuse does not always involve sexual intercourse or physical force. Rather, it is characterized usually by deception and coercion. Activities may include genital or anal contact; oral–genital contact; and insertion of objects; and can encompass incest or sexual assault by a relative or stranger.
Possible effects of childhood trauma on neuroendocrine systems
Corticotropin releasing hormone (CRH) is a 41 amino acid peptide essential in the activation of the pituitary gland, and a peptide hormone linked to behavior, notably the “fight or flight” response to a perceived threat. Research on the role of CRH under conditions of extreme stress has often relied upon animal models to test empirical hypotheses, because it is both unfeasible and unethical to contrive conditions of extreme trauma in people under laboratory conditions. Studies in non-human
Clinical implications of stress-related neuroendocrine dysregulation
One result of early childhood sexual abuse is an increased risk of PTSD. Patients with current PTSD, including survivors of childhood sexual abuse, demonstrate a dysregulation of hypothalamic-pituitary-adrenal activation.18 These individuals tend to have lower basal levels of cortisol, but they hypersecrete cortisol when pharmacologically or behaviorally challenged under experimental conditions of stress.19 Importantly, PTSD is associated with elevated CRH measured in the cerebrospinal fluid
Effects of childhood sexual abuse on pregnancy and childbirth
Early traumatic events may result in long-term vulnerability to fear and anxiety related responses in a number of contexts. In an experimental context, alterations in the startle response of sexual abuse survivors have been demonstrated.24 Even without the benefit of intervention, some abuse survivors are able to maintain the appearance of psychological adjustment. Nevertheless, these individuals may be vulnerable to the lasting consequences of abuse. Certain stressful life events may trigger
Discussion
Violence against women, particularly childhood sexual abuse, may hypothetically kindle, or result in elevated CRH gene expression in the brain and in the placenta during pregnancy. There is little doubt that early traumatic experiences can have a long-term impact. Those individuals traumatized by early sexual abuse may be more susceptible to stress vı́s a vı́s CRH dysregulation during a subsequent biopsychosocial stressor, such as pregnancy. That is, certain experiences associated with
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Cited by (29)
Non-invasive biomarkers of fetal brain development reflecting prenatal stress: An integrative multi-scale multi-species perspective on data collection and analysis
2020, Neuroscience and Biobehavioral ReviewsCitation Excerpt :In humans, differential methylation is associated with prenatal exposure to maternal depression (O’Connor et al., 2003; Teh et al., 2014), PS and birth weight (Filiberto et al., 2011; Mulligan et al., 2012; Vidal et al., 2014). Preconceptual or intra-gestational stress may result in increased cerebral and placental expressions of the CRH gene stimulating fetal cortisol and adrenocorticotropic hormone (ACTH) and signaling premature maturation of fetal tissue (Horan et al., 2000; Moog et al., 2016). Repeated stress exposure may dysregulate HPA axis and increase CRH and cortisol levels which in turn sensitizes women to stress experienced during pregnancy.
Childhood abuse, intimate partner violence, and placental abruption among Peruvian women
2019, Annals of EpidemiologyCitation Excerpt :Some PAs are caused by acute trauma, but many may arise from a longer term process hypothesized to begin early in pregnancy, suggesting that prepregnancy health factors may be important to predict risk [2]. For example, stress among women who were abused in childhood has been hypothesized to manifest in increased corticotropin-releasing hormone production by the placenta (pCRH) during pregnancy [28]. Limited evidence indicates that women who experienced childhood trauma have higher pCRH levels during the second half of pregnancy [29], and placentas from abruptions express more pCRH than placentas from spontaneous preterm labors [30].
Animal Models of Fetal Programming: Focus on Chronic Maternal Stress During Pregnancy and Neurodevelopment
2017, Animal Models for the Study of Human Disease: Second EditionConsequences of childhood sexual abuse experiences on dental care
2007, Journal of Psychosomatic ResearchCitation Excerpt :However, women with severe abuse more often reported an influence of CSA experiences on dental care, stress during dental visits, and preference for a female dentist to a male dentist. More severe forms of abuse are also known to increase the risk for health problems, such as mental, internal, or gynecological diseases, when compared to women with less severe forms of abuse [19–26,31,32]. While further investigations on the effect of age at the beginning of abuse or age for the duration of abuse and the number of perpetrators on specific long-term consequences of CSA are needed to confirm their unfavorable effects on long-term consequences of CSA, an increasing number of methodologically sound studies show that a combination of several types of abuse during childhood enhances the risk for health problems as adults [23,31].
Influence of childhood sexual abuse on pregnancy, delivery, and the early postpartum period in adult women
2006, Journal of Psychosomatic ResearchEffects of early-life stress on behavior and neurosteroid levels in the rat hypothalamus and entorhinal cortex
2006, Brain Research Bulletin