There is a limited literature on trauma exposure, pregnancy health and delivery complications. Indeed, there may be specific biological effects of early trauma ( Heim, Newport, Mletzko, Miller & Nemeroff, 2008 Bublitz et al.,2014) that may be relevant for pregnancy and delivery. Examining the impact of stress and trauma exposures that pre-date pregnancy is consistent with a life-course approach, which is gaining support for understanding the multiple influences of maternal biology on birth outcomes ( Wadhwa et al.,2011). Large-scale epidemiological studies have shown that maternal exposure to severe life events, just prior to conception or during pregnancy, is associated with significantly lower birthweight ( Class, Lichtenstein, Langstrom & D’Onofrio, 2011 Khashan et al, 2008) and preterm birth ( Khashan et al.,2008). This is significant given the high rates of trauma history, particularly in low income and high psychosocial risk women ( Putnam, Harris & Putnam, 2013 Putnam, 2003), the increasing awareness of trauma history in pregnant populations ( Onoye, Goebert, Morland, Matsu & Wright, 2009 Smith, Poschman, Cavaleri, Howell & Yonkers, 2006), and research documenting that depression and anxiety are comorbid with, and may be a consequence of, trauma exposure ( Putnam, 2003). One important limitation of many studies in this area is that they do not systematically assess traumatic life events. Empirical support for this hypothesis is widespread, as several studies assessing diverse samples demonstrate robust links between maternal prenatal depression or anxiety and higher rates of preterm birth and lower birthweight ( Ding et al, 2014 Grigoriadis et al, 2013 Grote et al, 2010 Ibanez et al., 2012 Wadhwa et al., 2011). Maternal mental health has been proposed as a potential risk factor because there are compelling biological mechanisms linking depression and anxiety to poor obstetric outcomes ( Wadhwa, Entringer, Buss & Lu, 2011), and mental health conditions covary with low socioeconomic status. Preterm birth and low birthweight are significant public health concerns with well-documented socioeconomic disparities however, the risk factors underlying these disparities are unclear ( Martin et al., 2012 Spong, Iams, Goldenberg, Hauck & Willinger, 2011). Screening pregnant women for trauma history and current mood symptoms is indicated. Childhood trauma exposure increases vulnerability for low birthweight delivery associated with prenatal mood disturbance. Trauma history magnified the effects of maternal prenatal mood on birth weight the moderating effect was limited to those who first experienced a trauma under 18 years of age F(14, 320) = 2.44, p =.005. Women with prenatal anxiety had significantly smaller babies than nonanxious women F(1, 322) = 5.32, p =. 011 compared to those with no trauma exposure. 003 and had a higher number of previous pregnancies t(356) = 2.77, p =. Women with antecedent trauma were more likely to have a history of depression χ 2(1, N = 358) = 19.2, p =.001 OR = 2.83, 95% CI, were younger at their first pregnancy t(356) = −2.97, p =. We examined the impact of trauma exposure and mood symptoms on obstetric outcomes in 358 women. Prenatal maternal mood may explain the adverse obstetric outcomes seen in disadvantaged populations yet the effects of trauma history are not well studied.
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