Differential pathways to preterm delivery for sexually abused and comparison women.

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.