Distinct forms of childhood maltreatment and their associations with subjective and objective sleep during pregnancy

OBJECTIVES: To examine the associations between distinct forms of childhood maltreatment and subjective/objective sleep during the second trimester of pregnancy. METHODS: Seventy-two pregnant women (n = 42 with an history of childhood maltreatment) were assessed between 18 and 20 weeks of gestation, a period considered relatively stable within pregnancy. Sleep was evaluated using both subjective and objective measures. Subjective sleep was measured using two validated self-report questionnaires, the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale. Objective sleep was measured using actigraphy (Mini-Mitter/Respironics) worn on the non-dominant wrist for seven consecutive days, accompanied by daily sleep diaries. Linear regression models were used to test associations between five distinct forms of childhood maltreatment (physical neglect, emotional neglect, physical abuse, emotional abuse, and sexual abuse) and sleep parameters (subjective and objective measures). Analyses were conducted using both dichotomous exposure scores (yes/no based on validated cutoffs) and continuous severity scores. All models simultaneously controlled for other forms of childhood maltreatment types, maternal education and household income. RESULTS: Pregnant women with a history of childhood emotional abuse reported significantly poorer subjective sleep, reflected in a 2-point higher on the Pittsburgh Sleep Quality score (2.0 ± .9, p = .03) compared to pregnant women without such histories. Objective actigraphy data indicated that pregnant women with a history of childhood sexual abuse obtained approximately 1 h less nighttime sleep (-62.1 ± 20.3 min, p = .003) compared to pregnant women who did not report childhood sexual abuse. Analyses using continuous severity scores for each childhood maltreatment type yielded consistent findings. CONCLUSIONS: Distinct forms of childhood maltreatment appear to have different associations with subjective and objective sleep during pregnancy. These findings underscore the importance of replication in larger and more diverse samples, as well as the need for studies that monitor sleep across pregnancy to clarify mechanisms and inform trauma-informed approaches to perinatal sleep health.