To date, there is insufficient empirical evidence exploring the long term health consequences of childhood exposure to trauma and violence. Although immediate consequences subsequent to the trauma, and mental health correlates have been well studied, health consequences related to either alteration in HPA functioning or consequences of negative life style behaviors, are not well understood. Although researchers have begun to look at reproductive outcomes, such as preterm delivery, with childhood trauma, the research that has been done to date has often failed to look at multiple forms of abuse, and has failed to consider the role of post- traumatic stress disorder (PTSD) as it relates to childhood trauma and health. The purpose of this dissertation is to investigate the long term reproductive health outcomes of children who have been exposed to childhood maltreatment. In order to examine this relationship, an observational dataset of a large cohort of female nurses, Nurses Health Study II, will be explored to see whether a relationship exists between various types of childhood maltreatment, including physical, sexual and emotional abuse, and pregnancy outcomes, such as, preterm delivery and second trimester pregnancy loss. Furthermore, the relationship of psychopathology to reproductive outcomes will be explored, by assessing the relationship between post-traumatic stress disorder (PTSD) symptoms with these pregnancy outcomes. Utilizing a life course model of health linking childhood exposures to adult health outcomes, this research will help explore the potential role of childhood trauma as an exposure with repercussions that last far beyond the immediate period of childhood and adolescence. There is a persistent need for research to provide empirical evidence with regards to the long term health impacts related to childhood maltreatment. This research can be used to support the promotion of high quality care to meet the needs of children who have suffered maltreatment, as well as increasing awareness of the need for prevention services that will be of benefit not only to children, but may also serve to decrease the burden of disease across the life course.
This research will investigate whether childhood abuse increases risk for poor pregnancy outcomes, and the possible role of mental health and health behaviors in the development of these conditions. This research would be important to increasing awareness among researchers, clinicians, and policy makers as to the long term consequences of childhood abuse, as well as beginning to address how these experiences might lead to poor health.
