Lifetime maternal experiences of abuse and risk of XXXX in two demographically distinct populations in Boston.

@entity1 @entity308 @entity458
BACKGROUND: To investigate lifetime history of interpersonal abuse and risk of @entity308 in socio-economically distinct populations in the same city. METHODS: We examined associations of physical and @entity458 with the risk of @entity308 in two cohorts in the Boston area, including 2128 @entity1 recruited from a large urban- and suburban-managed care organization (Project Viva) and 1509 @entity1 recruited primarily from urban community health centres (Project ACCESS). Protocols for the studies were designed in parallel to allow us to merge data to enhance ethnic and socio-economic diversity in the combined sample. In mid-pregnancy, the Personal Safety Questionnaire and Edinburgh Postnatal Depression Scale (EPDS) were administered in both cohorts. An EPDS score >=  13 indicated probable @entity308 . Logistic regression was used to estimate the odds ratio (OR) of @entity308 associated with lifetime abuse history. RESULTS: Project ACCESS @entity1 were twice as likely as Project Viva @entity1 to report symptoms consistent with @entity308 : 22% of Project ACCESS @entity1 had EPDS scores >=  13, compared with 11% of Project Viva @entity1 . Fifty-seven percent of @entity1 in ACCESS and 46% in Viva reported lifetime physical and/or @entity458 . In merged analysis, @entity1 reporting lifetime physical or @entity458 had an OR for mid-pregnancy @entity308 of 1.63 [95% confidence interval (95% CI): 1.29-2.07], adjusted for age and race/ethnicity. Lifetime histories of physical abuse [OR 1.48 (95% CI 1.15-1.90)] and @entity458 [OR 1.68 (95% CI 1.24-2.28)] were independently associated with @entity308 . When @entity1 /teen, pre-pregnancy adult and pregnancy life periods were considered simultaneously, abuse in childhood was independently associated with an OR of 1.23 (95% CI 1.00-1.59), pre-pregnancy adult abuse with an OR of 1.70 (95% CI 1.31-2.21) and abuse during pregnancy with an OR of 1.77 (95% CI 1.14-2.74). Further adjustment for childhood socio-economic position made no material difference, and there were no clear interactions between abuse and adult socio-economic position. CONCLUSIONS: Physical and @entity458 histories were positively associated with @entity308 in two economically and ethnically distinct populations. Stronger associations with recent abuse may indicate that the association of abuse with @entity308 wanes with time or may result from less accurate recall of remote events.
