(1084) Childhood Sexual Abuse Impacts 2nd Trimester Blood Pressure Nadir

Objective: Childhood trauma (CT) impacts health in adulthood with increased risks of hypertensive disease. Relationships between CT & maternal blood pressure (BP) during pregnancy are less clear. Using the Childhood Trauma Questionnaire (CTQ), we sought to assess relationships between CT & BP in each trimester (TRI) & BP nadir in the 2nd TRI.

Study Design: We performed a prospective longitudinal cohort study investigating associations between trauma & pregnancy outcomes at an urban safety net hospital. Participants who self- identified as Black completed the CTQ, a validated measure of 5 trauma domains in 1st TRI. CT was determined by CTQ total score: ≥35 with CT, < 35 no CT. Systolic (SBP) and diastolic (DBP) pressures were recorded in each TRI. SBP/DBP nadir was calculated (2nd TRI SBP/DBP – 1st TRI SBP/DBP) & compared between subjects with & without CT. Continuous variables were compared using Student T-tests or Rank Sum Tests. Categorical variables were compared using Chi-Square tests. Multivariable linear regression was performed controlling for age, race, 1st TRI body mass index, & chronic hypertension.  

Results: Of N=335, 34.3% & 65.6% had no CT & CT exposure respectively (Table 1). There were no differences in 1st, 2nd or 3rd TRI SBP/DBP or 2nd TRI SBP/DBP nadir between groups (Table 2). CT scores were further subtyped into 3 groups: sexual abuse (SA), physical abuse (PA) and emotional abuse (EA). SA scores were associated with lower 1st TRI SBP (β=-0.06, 95% CI -0.14-0.01, p=0.09). No significant differences in 1st TRI SBP were seen in those with PA or EA. Those with SA had a lower 2nd trimester SBP nadir compared to those without SA ( -1.7±10.5 vs -6.3±11.2, p=0.04).

Conclusion: CT is a concerning problem affecting many reproductive aged individuals. Using the detailed CTQ, our data innovatively demonstrates SA in childhood may mitigate vascular relaxation between 1st & 2nd TRI, a time where vascular relaxation is physiologically necessary. Future studies need to evaluate mechanisms driving the relationship between CT subtypes & gestational vascular dysregulation.