| PHYSICAL AND SEXUAL ABUSE VICTIMIZATION IN CHILDHOOD OR ADOLESCENCE AND RISK OF GESTATIONAL DIABETES . Susan Mason*, Deirdre Tobias, Cuilin Zhang, Frank Hu, Janet Rich-Edwards, (Harvard Medical School, ) |
| Background: Abuse victimization has been linked to a variety of chronic disease outcomes in adulthood. In a recent study, we found that women who were physically or sexually abused in childhood had a substantially increased risk of type 2 diabetes in middle age. Women with abuse histories may also have an increased risk of gestational diabetes mellitus (GDM), a pregnancy condition with shared metabolic characteristics, but no published studies have examined this association. We investigated the relationship between childhood abuse victimization and risk of GDM in the Nurses’ Health Study II (NHSII). Methods: In 2001, NHSII participants were asked about their experiences of physical and sexual abuse in childhood. A detailed pregnancy history, including the diagnosis of GDM in each pregnancy, was included in the 2009 NHSII questionnaire. We used a modified Poisson regression approach with generalized estimating equations to estimate risk ratios (RRs) and 95% confidence intervals (CIs) for GDM, as a function of severity of childhood physical and sexual abuse victimization. Results: Of 45,550 women included in the analyses, 8% reported severe physical abuse, and 5% reported multiple experiences of forced sexual activity in childhood or adolescence. Approximately 5% had one or more pregnancies complicated by GDM. In models adjusted for childhood socioeconomic variables, childhood body size, and family history of diabetes, severe physical abuse was associated with a 52% increase in GDM risk (RR=1.52; 95% CI: 1.32, 1.75). More than one experience of forced sexual activity was associated with a 30% increase in GDM risk (95% CI: 1.08, 1.56). Compared to women without a history of abuse, women with a history of sexual abuse in addition to severe physical abuse were found to have a 77% increase in risk of developing GDM (RR=1.77; 95% CI: 1.48, 2.12). Conclusion: Childhood abuse victimization is associated with increased risk of GDM in adulthood. |