The Consistency of Maternal Childhood Abuse Reporting in Pregnancy and the Postpartum Period.

Abstract

Background: Toxic stress resulting from childhood abuse can lead to poorer physical and mental health for pregnant women and their unborn children. To provide a clinical response to these experiences, momentum to incorporate questionnaires about childhood adversity, including abuse, into patient care is building. Limiting factors to this initiative are concerns regarding the consistency of abuse reporting before age 18. The current study evaluated the consistency of retrospective child abuse reports using two different questionnaires and examined factors that predict inconsistency. Method: A sample of 1,912 women from a prospective longitudinal birth cohort reported on physical, sexual, and emotional abuse experienced before age 18 at 34-36 weeks of pregnancy using an extended questionnaire and again at 36 months postpartum using a short-form questionnaire. Psychosocial factors, including depression, anxiety, stress, and social support at both time points were assessed as predictors of potential inconsistency. Results: The majority of women were consistent in their child abuse reporting from pregnancy to the postpartum period (65.1%-90%). Higher rates of childhood abuse were reported in the postpartum period. Multivariable logistic regression revealed that higher maternal depression in pregnancy (odds ratio [OR] = 1.04, 95% confidence interval [CI] = 1.01-1.08) predicted inconsistency in report of all abuse experiences, while higher social support in pregnancy predicted less inconsistency in physical abuse (OR = 0.99, 95% CI = 0.98-0.99) in particular. Higher postpartum social support was associated with less inconsistency overall, whereas higher depression was associated with increased inconsistency in physical abuse reporting (OR = 1.03, 95% CI = 1.01-1.06). Conclusions: Upon reevaluation, a questionnaire with clear adversity descriptions yielded greater retrospective reports of childhood abuse in the postpartum period. Women of higher psychosocial risk may be at greatest risk of inconsistent abuse reports. Thus, the questionnaire structure and individual characteristics of the reporter may play an important role in the report obtained.