Women’s Health
Reproductive trajectories from menarche to menopause: identifying patterns and differences by childhood maltreatment. Kaitlyn K Stanhope* Kaitlyn Stanhope Audrey Gaskins Erica P Gunderson Catherine Kim Cora Lewis
Objective: Few studies to date have considered holistic methods to capture the reproductive life course, largely relying on single indicators. By identifying unique trajectories of reproductive events over the reproductive years we can improve the understanding of how early life experiences impact reproductive outcomes. The goal was to identify unique trajectories of reproductive events across the life course and to explore whether socioeconomic position in early life (parental educational attainment) or childhood maltreatment determine trajectory membership.
Methods: We used data from the Coronary Artery Risk Development in Young Adults (CARDIA) study on all female-bodied participants (n = 2800). We included self-reported reproductive events (complicated pregnancies (with a hypertensive disorder of pregnancy, preterm birth, cesarean delivery, and/or gestational diabetes), uncomplicated pregnancies, irregular menses, and birth control use) and coded each for each year of the reproductive life course (individual determined from reported date of menarche to menopause or loss-to-follow-up). We fit group-based trajectory models and used model fit to identify optimal trajectories. We determine associations with self-reported childhood physical or emotional maltreatment using polytomous logistic regression models controlling for baseline age, parental educational attainment, and race as potential confounders.
Results: We identified three unique trajectories of reproductive events (1: (n = 1,161); 2: (n=498); 3: (n = 1,128)). Group 1 had the youngest age at first pregnancy (mean 19.8, (standard deviation 4.7), 2: 29.29, (6.3), 3: 26.72, (6.2)) Any reported childhood maltreatment was associated with membership in group 1 (adjusted odds ratio: 1.49, 95% confidence interval (1.15, 1.93) versus group 2. Trajectories were similar by baseline obesity status.
Conclusion: Childhood maltreatment is associated with a pattern of earlier childbearing.
