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The association between Adverse Childhood Experiences and pain with onset during pregnancy
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
2013 (English)Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
Abstract [en]

Adverse Childhood Experiences (ACE) includes a range of traumatic events during the first 18 years in life. Previous studies have shown that ACEs increase the risk for various health problems in adulthood. It is unknown if ACEs affect development of pain during pregnancy. The aim was to examine the association and the potential impact of adverse childhood experiences on the experienced pain with onset during pregnancy among women in third trimester of pregnancy. A quantitative, cohort study was performed, 142 pregnant women responded to questionnaires about ACE and their experienced pain. The majority, 62%, had experienced ≥1 category of ACEs, 72% of the women had pain of any kind. The ACE score was associated to the number of pain areas (rs=0.185, N=142, p=0.027). After adjusting for potential confounders the ACE score was not associated to the number of pain areas (B= 0.473, p=0.067) but country of birth was (B=-2.926, p=0.006). Exposure to childhood physical abuse was associated to having pain from more areas of the body (B=2.317; R2=0.13; p=0.004). No association was found between ACE score and pain intensity, having pain, back pain, pelvic pain or leg pain. The accumulated exposure to ACE was associated to the number of pain areas during pregnancy but it was likely a mediating effect of the country of birth. Childhood physical abuse was the only ACE category that was associated with more pain areas. This was a pilot study, the results should be interpreted with caution.

Abstract [sv]

Adverse Childhood Experiences (ACE) är ett begrepp som inkluderar ett spektrum av negativa händelser under barndomen. Tidigare studier har visat att ACE ökar risken för olika hälsoproblem i vuxen ålder. Det är okänt hur ACE påverkar smärtutvecklingen under graviditet. Målet var att undersöka sambandet och den potentiella påverkan av ACE på den upplevda smärtan med debut under graviditeten bland kvinnor i tredje trimestern. En kvantitativ, retrospektiv kohortstudie gjordes där 142 kvinnor, gravida i tredje trimestern, svarade på enkäter om uppväxtvillkor, smärtutbredning samt smärtintensitet. Majoriteten, 62% av deltagarna, hade erfarenhet av minst en kategori av ACEs, 72% av deltagarna hade smärta i någon del av kroppen. Det fanns ett samband mellan summan av antalet olika ACE- kategorier (ACE-score) och antalet områden på kroppen som kvinnorna upplevde smärta från (rs=0.185, N=142, p=0.027). Efter att ha justerat för potentiella confounders hade ACE-score inte någon signifikant påverkan (B= 0.473, p=0.067) men det hade födelselandet (B=-2.926, p=0.006). Det fanns ett samband mellan att vara utsatt för fysisk misshandel under barndomen och antalet smärtområden, kvinnor med den erfarenheten hade smärta från fler områden än icke utsatta (B=2.317; R2=0.13; p=0.004). Inga samband kunde ses mellan ACE-score och smärtintensitet, att ha smärta, ryggsmärta, bäckensmärta eller bensmärta. Det fanns ett samband mellan den ackumulerade exponeringen för ACE och antalet smärtområden under graviditeten men det var troligtvis en effekt av födelselandets påverkan. Studien var liten och dess resultat borde därför tolkas med en viss försiktighet.

Place, publisher, year, edition, pages
2013.
Keyword [en]
adverse childhood experiences, pregnancy, pain, back pain, pelvic pain
Keyword [sv]
adverse childhood experiences, graviditet, smärta, ryggsmärta, bäckensmärta
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-201291OAI: oai:DiVA.org:uu-201291DiVA: diva2:626714
Subject / course
Public Health
Educational program
Master Programme in Public Health
Supervisors
Examiners
Projects
PrePreg
Available from: 2013-06-10 Created: 2013-06-10 Last updated: 2013-06-18Bibliographically approved

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