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Childhood maltreatment and pre-pregnancy obesity: a comparison of obese, overweight, and normal weight pregnant women

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Abstract

Pre-pregnancy overweight and obesity is associated with poor health outcomes for the mother and the child. General population studies suggest that childhood maltreatment is associated with obesity in adulthood. The aim of our study was to examine the association between pre-pregnancy overweight and obesity and a history of childhood abuse or neglect including different stages of severity of abuse and neglect. Three hundred twenty-six normal weight, overweight, or obese pregnant women reported demographic data, height and weight, and general psychological distress at 18–22 weeks of gestation. Childhood maltreatment was assessed using the Childhood Trauma Questionnaire. Associations were examined using logistic regression analyses and a reference group of normal weight women. Fifty percent reported a history of abuse or neglect. After adjusting for age, education, income, marital status, and the number of previous children, pre-pregnancy overweight and obesity were strongly associated with severe physical abuse (overweight: OR = 8.33, 95 % CI 1.48–47.03; obesity: OR = 6.31, 95 % CI 1.06–37.60). Women with severe physical neglect (OR = 4.25, 95 % CI 1.23–14.74) were at increased risk of pregnancy overweight. We found a dose-response relationship between physical abuse and pre-pregnancy overweight and obesity. Whereas other studies report an association between childhood maltreatment and pre-pregnancy obesity, this is the first study that found an association between childhood maltreatment and pre-pregnancy overweight. Considering the severe health risks of pre-pregnancy overweight and obesity and the long-term consequences of childhood maltreatment, affected women constitute a subgroup with special needs in prenatal care. Further research is needed to improve the understanding of the underlying mechanisms.

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Acknowledgments

We thank Prof. Mathias Fasshauer for his helpful comments on the manuscript. We also thank Linde Büge, Sophie Erlenkamp, Agnes Gottwald, and the staff of the Department of Obstetrics at the University Hospital Leipzig for their support during the data acquisition process, and all the women who participated in the study.

Conflict of interest

The authors declare that they have no competing interests.

Funding

The authors did not receive any third party funding for this work. The project was exclusively funded by internal funds (Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Germany).

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Ethics approval

The study was conducted according to the Declaration of Helsinki and was approved by the Ethical Committee of the University of Leipzig, Germany.

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The women included in the study provided written informed consent.

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Authors and Affiliations

  1. Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Semmelweisstraße 10, 04103, Leipzig, Germany

    Michaela Nagl, Jana Steinig, Grit Klinitzke & Anette Kersting

  2. Department of Obstetrics, University of Leipzig, Liebigstraße 20a, 04103, Leipzig, Germany

    Holger Stepan

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  1. Michaela Nagl
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  2. Jana Steinig
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Correspondence to Michaela Nagl.

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Nagl, M., Steinig, J., Klinitzke, G. et al. Childhood maltreatment and pre-pregnancy obesity: a comparison of obese, overweight, and normal weight pregnant women. Arch Womens Ment Health 19, 355–365 (2016). https://doi.org/10.1007/s00737-015-0573-5

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