Background: Up to one in five women experience childhood sexual abuse (CSA) globally. Pregnancy and early parenthood might represent a time of heightened vulnerability for women who have experienced CSA. We aimed to describe disparities in social and financial resources, mental health, and parenting in pregnancy and early parenthood, between women reporting experience of CSA and women not reporting experience of CSA.
Methods: This multicohort observational study included data from three longitudinal, population-based, preconception cohorts, two in Australia and one in New Zealand. The Victorian Intergenerational Health Cohort Study (VIHCS) included 398 women with 609 children; the Australian Temperament Project Generation 3 (ATPG3) included 400 women with 697 children; and The Dunedin Multidisciplinary Health and Development Study–Parenting Study (Dunedin-PS) included 361 women with 361 children. Women aged 23–26 years reported on various experiences of CSA occurring before age 16 years, with measures varying in restrictions by perpetrator characteristics, included acts, and measure length. Participants were then assessed during subsequent pregnancies and early parenthood on mental health, parenting, and social and financial resources. Linear regression models were used to calculate standardised β coefficients for each outcome in each cohort.
Findings: The reported prevalence of CSA before age 16 years was 60 (15%) of 393 in VIHCS, 23 (7%) of 332 in ATPG3, and 113 (31%) of 361 in Dunedin-PS. In all cohorts, women reporting experience of CSA had increased social and mental health risks (eg, depressive symptoms and partner coercive control), and reduced protective factors (eg, income, social support, partner relationship quality) during pregnancy and early parenthood compared with those not reporting experience of CSA. β coefficients were largest and most consistent for social support (VIHCS 1 year postpartum: β –0·61 [95% CI –0·87 to –0·35]; ATPG3 1 year postpartum: β –0·52 [–0·94 to –0·10]; and Dunedin-PS 3 years postpartum: β –0·43 [–0·65 to –0·22]). Associations with parenting were generally small to null, and less consistent across studies.
Interpretation: In our multicohort observational study, women reporting experience of CSA had increased mental health risks during pregnancy and early parenthood, as well as substantially lower levels of social protective factors for maternal and child health, compared with women not reporting experience of CSA. As previously neglected intervention targets, these social resources might be particularly important foci within trauma-informed clinical care guidelines for women who have experienced CSA, to buffer risks for women and their children.
- 9926849393601891
- Childhood sexual abuse and maternal social and financial resources, mental health, and parenting outcomes in pregnancy and early parenthood: a multicohort observational study
- Elizabeth A SpryStephanie R AarsmanS Ghazaleh DashtiHelena McAnallyChristopher J GreenwoodHayley GuineyRaquel CatalaoJay BelskyJacqui A MacdonaldPrimrose LetcherDelyse M HutchinsonKimberly C ThomsonEbony J BidenJennifer McIntoshLouise M HowardStephanie J BrownJessica A KerrGeorge C PattonReremoana TheodoreRobert J HancoxCraig A Olsson
- The Lancet Obstetrics, Gynaecology, & Women’s Health
- Psychology; Public Health (DSM); Dunedin Multidisciplinary Health and Development Research Unit (DMHDRU); Psychological Medicine (UOC)
- Elsevier
- Australian Research Council (Australia, Canberra) - ARCNational Health and Medical Research Council (Australia, Canberra) - NHMRCHealth Research Council of New Zealand (New Zealand, Auckland) - HRCDeakin University (Australia, Burwood)
- 20/02/2026
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- English
- Journal article