Childhood Maltreatment History, Posttraumatic Relational Sequelae, and Prenatal Care Utilization. Issue 4 (17th June 2013)

• Record Type: Journal Article
• Authors: Bell, Sue Anne; Seng, Julia
• Is Part Of: Journal of obstetric, gynecologic, and neonatal nursing. Volume 42:Issue 4(2013)
• Page Start: 404
• Page End: 415
• Publication Date: 2013-06-17
• Subjects: Maternity nursing -- Periodicals; Gynecologic nursing -- Periodicals; Newborn infants -- Care -- Periodicals; Pediatric nursing -- Periodicals; Genital Diseases, Female -- nursing; Obstetrical Nursing; Pediatric Nursing; 618.2
• DOI: 10.1111/1552-6909.12223
• Languages: English
• ISSNs: 0884-2175

Abstract

<abstract abstract-type="main"> <title>ABSTRACT</title> <sec id="jogn12223-sec-0010" sec-type="section"> <title>Objective</title> <p>To test the hypothesis that childhood maltreatment history would be associated with inadequate prenatal care utilization.</p> </sec> <sec id="jogn12223-sec-0020" sec-type="section"> <title>Design</title> <p>A post‐hoc analysis of a prospective cohort study of the effects of post traumatic stress disorder (PTSD) on pregnancy outcomes.</p> </sec> <sec id="jogn12223-sec-0030" sec-type="section"> <title>Setting</title> <p>Recruitment took place via prenatal clinics from three academic health systems in southeast Michigan.</p> </sec> <sec id="jogn12223-sec-0040" sec-type="section"> <title>Participants</title> <p>This analysis included 467 diverse, nulliparous, English‐speaking adult women expecting their first infants.</p> </sec> <sec id="jogn12223-sec-0050" sec-type="section"> <title>Methods</title> <p>Data were gathered from structured telephone interviews at two time points in pregnancy and from prenatal medical records.</p> </sec> <sec id="jogn12223-sec-0060" sec-type="section"> <title>Results</title> <p>Contrary to our hypothesis, history of childhood maltreatment was associated with better likelihood of using adequate prenatal care. Risk for inadequate prenatal care occurred in association with the posttraumatic stress and interpersonal sensitivity that can result from maltreatment, with low alliance with the maternity care provider, and with public insurance coverage. Prior mental health treatment was associated with using adequate prenatal care.</p> </sec> <sec id="jogn12223-sec-0070" sec-type="section"> <title>Conclusion</title> <p>When childhood maltreatment survivors were resilient or had used mental health treatment, they were more likely to utilize adequate prenatal care. The maternity care relationship or service delivery model (e.g., no continuity of care) as well as structural factors may adversely affect utilization among PTSD‐affected survivors. Since inadequate care was associated with adverse outcomes, further studies of these modifiable factors are warranted.</p> </sec> </abstract>