Skip to main content Accessibility help
Hostname: page-component-7ccbd9845f-s2vjv Total loading time: 0.688 Render date: 2023-01-31T18:31:51.680Z Has data issue: true Feature Flags: { "useRatesEcommerce": false } hasContentIssue true

Associations between childhood maltreatment, poor sleep, and prenatal distress in pregnant adolescents

Published online by Cambridge University Press:  08 February 2021

Sophie Foss*
Department of Psychiatry, Columbia University Medical Center, New York, NY, USA Department of Psychiatry, Boston Children's Hospital, Boston, MA, USA Department of Psychiatry, Harvard Medical School, Boston, MA, USA
Hanna C. Gustafsson
Department of Psychiatry, Columbia University Medical Center, New York, NY, USA Department of Psychiatry, Oregon Health and Science University, Portland, OR, USA
Obianuju O. Berry
Department of Psychiatry, Columbia University Medical Center, New York, NY, USA New York State Psychiatric Institute, New York, NY, USA
Alison E. Hipwell
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
Elizabeth A. Werner
Department of Ob/Gyn, Columbia University Medical Center, New York, NY, USA
Bradley S. Peterson
Department of Psychiatry, Children's Hospital Los Angeles, Los Angeles, CA, USA
Catherine Monk
New York State Psychiatric Institute, New York, NY, USA Department of Ob/Gyn, Columbia University Medical Center, New York, NY, USA
Author for Correspondence: Sophie Foss, Department of Psychiatry, Boston Children's Hospital/Harvard Medical School, 300 Longwood Avenue BCH 3222, Boston, MA 02115, USA; Email:


Childhood maltreatment (CM) is a known risk factor for adolescent pregnancy. Sleep disturbances and psychological distress, both common negative sequelae of CM, often co-occur during pregnancy, although directionality remains unclear. Furthermore, little is known about how CM affects sleep–distress associations during pregnancy. In pregnant adolescents, we examined: (a) whether there are significant predictive associations from CM to sleep quality and distress and (b) bidirectional influences of distress and sleep quality. Healthy pregnant adolescents (n = 204) were recruited before or during the 2nd trimester. CM was assessed at enrollment; sleep quality and distress were assessed in the 2nd and 3rd trimesters. Hypotheses were tested using path analysis. Findings revealed that CM was associated with worse 2nd trimester sleep quality and distress (β = .19, p < .05 for sleep; β = .30, p < .001 for distress). Higher levels of 2nd trimester distress were associated with lower 3rd trimester sleep quality (β = .19, p < .05). Findings provide novel information about (a) associations from CM to prenatal mood and sleep in pregnant adolescents, and (b) sleep–distress directionality over the course of pregnancy. These results have implications for better understanding the ways in which CM potentially exerts influences later in life, and for targeting interventions to address physical and mental health during pregnancy.

Regular Article
© The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)


Abajobir, A. A., Kisely, S., Williams, G., Strathearn, L., & Najman, J. M. (2017). Childhood maltreatment and adulthood poor sleep quality: A longitudinal study. Journal of Internal Medicine, 47, 879888. doi:10.1111/imj.13459CrossRefGoogle ScholarPubMed
Alderdice, F., & Lynn, F. (2011). Factor structure of the prenatal distress questionnaire. Midwifery, 27, 553559.CrossRefGoogle ScholarPubMed
Alderdice, F., Lynn, F., & Lobel, M. (2012). A review and psychometric evaluation of pregnancy-specific stress measures. Journal of Psychosomatic Obstetrics & Gynecology, 33, 6277.CrossRefGoogle ScholarPubMed
Anda, R. F., Felitti, V. J., Bremner, J. D., Walker, J. D., Whitfield, C., Perry, B. D., … Giles, W. H. (2006). The enduring effects of abuse and related adverse experiences in childhood. A convergence of evidence from neurobiology and epidemiology. European Archives of Psychiatry and Clinical Neuroscience, 256, 174186. doi:10.1007/s00406-005-0624-4CrossRefGoogle ScholarPubMed
Arbuckle, J. L., Marcoulides, G. A., & Schumacker, R. E. (1996). Full information estimation in the presence of incomplete data. Advanced Structural Equation Modeling: Issues and Techniques, 243, 277.Google Scholar
Bader, K., Schafer, V., Schenkel, M., Nissen, L., & Schwander, J. (2007). Adverse childhood experiences associated with sleep in primary insomnia. Journal of Sleep Research, 16, 285296. doi:10.1111/j.1365-2869.2007.00608.xCrossRefGoogle ScholarPubMed
Baldwin, J. R., Reuben, A, Newbury, J. B., & Danese, A. (2019). Agreement between prospective and retrospective measures of childhood maltreatment: a systematic review and meta-analysis. JAMA Psychiatry, 76(6), 584593.CrossRefGoogle ScholarPubMed
Baum, K. T., Desai, A., Field, J., Miller, L. E., Rausch, J., & Beebe, D. W. (2014). Sleep restriction worsens mood and emotion regulation in adolescents. Journal of Child Psychology and Psychiatry, 55, 180190. doi:10.1111/jcpp.12125CrossRefGoogle ScholarPubMed
Bernstein, D. P., Ahluvalia, T., Pogge, D., & Handelsman, L. (1997). Validity of the childhood trauma questionnaire in an adolescent psychiatric population. Journal of the American Academy of Child & Adolescent Psychiatry, 36, 340348. doi:10.1097/00004583-199703000-00012CrossRefGoogle Scholar
Bernstein, D. P., Stein, J. A., Newcomb, M. D., Walker, E., Pogge, D., Ahluvalia, T., … Desmond, D. (2003). Development and validation of a brief screening version of the childhood trauma questionnaire. Child Abuse & Neglect, 27, 169190.CrossRefGoogle ScholarPubMed
Blair, L. M., Porter, K., Leblebicioglu, B., & Christian, L. M. (2015). Poor sleep quality and associated inflammation predict preterm birth: Heightened risk among African Americans. Sleep, 38, 12591267.CrossRefGoogle ScholarPubMed
Blinn-Pike, L., Berger, T., Dixon, D., Kuschel, D., & Kaplan, M. (2002). Is there a causal link between maltreatment and adolescent pregnancy? A literature review. Perspectives on Sexual and Reproductive Health , 34, 6875.CrossRefGoogle Scholar
Brewin, C. R., Andrews, B., & Gotlib, I. H. (1993). Psychopathology and early experience: A reappraisal of retrospective reports. Psychological Bulletin, 113, 8298. doi:10.1037/0033-2909.113.1.82CrossRefGoogle ScholarPubMed
Brindle, R. C., Cribbet, M. R., Samuelsson, L. B., Gao, C., Frank, E., Krafty, R. T., … Hall, M. H. (2018). The relationship between childhood trauma and poor sleep health in adulthood. Psychosomatic Medicine, 80, 200207.CrossRefGoogle ScholarPubMed
Brown, J., Cohen, P., Johnson, J. G., & Smailes, E. M. (1999). Childhood abuse and neglect: Specificity of effects on adolescent and young adult depression and suicidality. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 14901496.CrossRefGoogle Scholar
Bublitz, M. H., Parade, S., & Stroud, L. R. (2014). The effects of childhood sexual abuse on cortisol trajectories in pregnancy are moderated by current family functioning. Biological Psychology, 103, 152157.CrossRefGoogle ScholarPubMed
Bunting, L., & McAuley, C. (2004). Research review: Teenage pregnancy and parenthood: The role of fathers. Child & Family Social Work, 9, 295303.CrossRefGoogle Scholar
Buysse, D. J., Reynolds, C. F., Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989). The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research. Psychiatry Research, 28, 193213.CrossRefGoogle ScholarPubMed
Carskadon, M. A. (2011). Sleep in adolescents: The perfect storm. Pediatric Clinics of North America, 58, 637647. doi:10.1016/j.pcl.2011.03.003CrossRefGoogle ScholarPubMed
Chapman, D. P., Liu, Y., Presley-Cantrell, L. R., Edwards, V. J., Wheaton, A. G., Perry, G. S., & Croft, J. B. (2013). Adverse childhood experiences and frequent insufficient sleep in 5 US states, 2009: A retrospective cohort study. BMC Public Health, 13, 3.CrossRefGoogle Scholar
Chapman, D. P., Whitfield, C. L., Felitti, V. J., Dube, S. R., Edwards, V. J., & Anda, R. F. (2004). Adverse childhood experiences and the risk of depressive disorders in adulthood. Journal of Affective Disorders, 82, 217225.CrossRefGoogle ScholarPubMed
Cicchetti, D., Rogosch, F. A., Gunnar, M. R., & Toth, S. L. (2010). The differential impacts of early physical and sexual abuse and internalizing problems on daytime cortisol rhythm in school-aged children. Child Development, 81, 252269. doi:10.1111/j.1467-8624.2009.01393.xCrossRefGoogle ScholarPubMed
Cohen, P., Brown, J., & Smaile, E. (2001). Child abuse and neglect and the development of mental disorders in the general population. Development and Psychopathology, 13, 981999.CrossRefGoogle ScholarPubMed
De Bellis, M. D., Dahl, R. E., Perel, J. M., Birmaher, B., al-Shabbout, M., Williamson, D. E., … Ryan, N. D. (1996). Nocturnal ACTH, cortisol, growth hormone, and prolactin secretion in prepubertal depression. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 11301138. doi:10.1097/00004583-199609000-00010CrossRefGoogle ScholarPubMed
Edwards, V. J., Holden, G. W., Felitti, V. J., & Anda, R. F. (2003). Relationship between multiple forms of childhood maltreatment and adult mental health in community respondents: Results from the adverse childhood experiences study. The American Journal of Psychiatry, 160, 14531460. doi:10.1176/appi.ajp.160.8.1453CrossRefGoogle ScholarPubMed
Edwards, R. C., Thullen, M. J., Isarowong, N., Shiu, C. S., Henson, L., & Hans, S. L. (2012). Supportive relationships and the trajectory of depressive symptoms among young, African American mothers. Journal of Family Psychology, 26, 585594. doi:10.1037/a0029053CrossRefGoogle ScholarPubMed
Field, T., Diego, M., Hernandez-Reif, M., Figueiredo, B., Schanberg, S., & Kuhn, C. (2007). Sleep disturbances in depressed pregnant women and their newborns. Infant Behavior and Development, 30, 127133.CrossRefGoogle ScholarPubMed
Garwood, S. K., Gerassi, L., Jonson-Reid, M., Plax, K., & Drake, B. (2015). More than poverty: The effect of child abuse and neglect on teen pregnancy risk. Journal of Adolescent Health, 57, 164168. doi:10.1016/j.jadohealth.2015.05.004CrossRefGoogle ScholarPubMed
Gelaye, B., Kajeepeta, S., Zhong, Q. Y., Borba, C. P., Rondon, M. B., Sanchez, S. E., … Williams, M. A. (2015). Childhood abuse is associated with stress-related sleep disturbance and poor sleep quality in pregnancy. Sleep Medicine, 16, 12741280. doi:10.1016/j.sleep.2015.07.004CrossRefGoogle ScholarPubMed
Geller, P. A. (2004). Pregnancy as a stressful life event. CNS Spectrums, 9, 188197. doi:10.1017/S1092852900008981CrossRefGoogle ScholarPubMed
Gilbert, R., Widom, C. S., Browne, K., Fergusson, D., Webb, E., & Janson, S. (2009). Burden and consequences of child maltreatment in high-income countries. Lancet, 373, 6881. doi:10.1016/S0140-6736(08)61706-7CrossRefGoogle ScholarPubMed
Gonzalez, A. (2013). The impact of childhood maltreatment on biological systems: Implications for clinical interventions. Paediatrics & Child Health, 18, 415418.Google ScholarPubMed
Gradisar, M., Gardner, G., & Dohnt, H. (2011). Recent worldwide sleep patterns and problems during adolescence: A review and meta-analysis of age, region, and sleep. Sleep Medicine, 12, 110118. doi:10.1016/j.sleep.2010.11.008CrossRefGoogle Scholar
Grassi-Oliveira, R., & Stein, L. M. (2008). Childhood maltreatment associated with PTSD and emotional distress in low-income adults: The burden of neglect. Child Abuse & Neglect, 32, 10891094. doi:10.1016/j.chiabu.2008.05.008CrossRefGoogle ScholarPubMed
Greenfield, E. A., Lee, C., Friedman, E. L., & Springer, K. W. (2011). Childhood abuse as a risk factor for sleep problems in adulthood: Evidence from a US national study. Annals of Behavioral Medicine, 42, 245.CrossRefGoogle Scholar
Heleniak, C., Jenness, J. L., Vander Stoep, A., McCauley, E., & McLaughlin, K. A. (2016). Childhood maltreatment exposure and disruptions in emotion regulation: A transdiagnostic pathway to adolescent internalizing and externalizing psychopathology. Cognitive Therapy and Research, 40, 394415.CrossRefGoogle ScholarPubMed
Hodgkinson, S., Beers, L., Southammakosane, C., & Lewin, A. (2014). Addressing the mental health needs of pregnant and parenting adolescents. Pediatrics, 133, 114122. doi:10.1542/peds.2013-0927CrossRefGoogle ScholarPubMed
Hu, L. t., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6, 155.CrossRefGoogle Scholar
Hussey, J. M., Chang, J. J., & Kotch, J. B. (2006). Child maltreatment in the United States: Prevalence, risk factors, and adolescent health consequences. Pediatrics, 118, 933942. doi:10.1542/peds.2005-2452CrossRefGoogle ScholarPubMed
Johnson, E. O., Roth, T., & Breslau, N. (2006). The association of insomnia with anxiety disorders and depression: Exploration of the direction of risk. Journal of Psychiatric Research, 40, 700708. doi:10.1016/j.jpsychires.2006.07.008CrossRefGoogle ScholarPubMed
Kajeepeta, S., Gelaye, B., Jackson, C. L., & Williams, M. A. (2015). Adverse childhood experiences are associated with adult sleep disorders: A systematic review. Sleep Medicine, 16, 320330.CrossRefGoogle ScholarPubMed
Kamysheva, E., Skouteris, H., Wertheim, E. H., Paxton, S. J., & Milgrom, J. (2010). A prospective investigation of the relationships among sleep quality, physical symptoms, and depressive symptoms during pregnancy. Journal of Affective Disorders, 123, 317320.CrossRefGoogle ScholarPubMed
Kessler, R. C., McLaughlin, K. A., Green, J. G., Gruber, M. J., Sampson, N. A., Zaslavsky, A. M., … Williams, D. R. (2010). Childhood adversities and adult psychopathology in the WHO world mental health surveys. British Journal of Psychiatry, 197, 378385. doi:10.1192/bjp.bp.110.080499CrossRefGoogle ScholarPubMed
Klein, J. D., & American Academy of Pediatrics Committee on Adolescence (2005). Adolescent pregnancy: Current trends and issues. Pediatrics, 116, 281286. doi:10.1542/peds.2005-0999CrossRefGoogle ScholarPubMed
Lobel, M. (1998) Pregnancy and mental health. In Friedman, H. S. (Ed.), Encyclopedia of mental health (pp. 229238). San Diego, CA: Academic Press.Google Scholar
Lobel, M., Cannella, D. L., Graham, J. E., DeVincent, C., Schneider, J., & Meyer, B. A. (2008). Pregnancy-specific stress, prenatal health behaviors, and birth outcomes. Health Psychology, 27, 604615. doi:10.1037/a0013242CrossRefGoogle ScholarPubMed
Lynn, F. A., Alderdice, F. A., Crealey, G. E., & McElnay, J. C. (2011). Associations between maternal characteristics and pregnancy-related stress among low-risk mothers: An observational cross-sectional study. International Journal of Nursing Studies, 48, 620627.CrossRefGoogle ScholarPubMed
Matthews, T. J., & Hamilton, B. E. (2019). Total fertility rates by state and race and Hispanic origin: United States, 2017. National Vital Statistics Reports, 68, 111.Google ScholarPubMed
McPhie, M. L., Weiss, J. A., & Wekerle, C. (2014). Psychological distress as a mediator of the relationship between childhood maltreatment and sleep quality in adolescence: Results from the maltreatment and adolescent pathways (MAP) longitudinal study. Child Abuse & Neglect, 38, 20442052. doi:10.1016/j.chiabu.2014.07.009CrossRefGoogle ScholarPubMed
Mindell, J. A., Cook, R. A., & Nikolovski, J. (2015). Sleep patterns and sleep disturbances across pregnancy. Sleep Medicine, 16, 483488. doi:10.1016/j.sleep.2014.12.006CrossRefGoogle ScholarPubMed
Mollborn, S., & Morningstar, E. (2009). Investigating the relationship between teenage childbearing and psychological distress using longitudinal evidence. Journal of Health and Social Behavior, 50, 310326. doi:10.1177/002214650905000305CrossRefGoogle ScholarPubMed
Moore, M. S. (1989). Disturbed attachment in children: A factor in sleep disturbance, altered dream production and immune dysfunction: I. Not safe to sleep: chronic sleep disturbance in anxious attachment. Journal of Child Psychotherapy, 15, 99111. doi:10.1080/00754178808254836Google Scholar
Muthén, L. K., & Muthén, B. O. (1998–2017). Mplus user's guide (7th ed.). Los Angeles: Muthén & Muthén.Google Scholar
Noll, J. G., & Shenk, C. E. (2013). Teen birth rates in sexually abused and neglected females. Pediatrics, 131, e1181e1187. doi:10.1542/peds.2012-3072CrossRefGoogle ScholarPubMed
Noll, J. G., Shenk, C. E., & Putnam, K. T. (2009). Childhood sexual abuse and adolescent pregnancy: A meta-analytic update. Journal of Pediatric Psychology, 34, 366378. doi:10.1093/jpepsy/jsn098CrossRefGoogle ScholarPubMed
Noll, J. G., Trickett, P. K., Susman, E. J., & Putnam, F. W. (2006). Sleep disturbances and childhood sexual abuse. Journal of Pediatric Psychology, 31, 469480. doi:10.1093/jpepsy/jsj040CrossRefGoogle ScholarPubMed
Norman, R. E., Byambaa, M., De, R., Butchart, A., Scott, J., & Vos, T. (2012). The long-term health consequences of child physical abuse, emotional abuse, and neglect: A systematic review and meta-analysis. PLoS Medicine, 9, e1001349. doi:10.1371/journal.pmed.1001349CrossRefGoogle ScholarPubMed
Obeysekare, J. L., Cohen, Z. L., Coles, M. E., Pearlstein, T. B., Monzon, C., Flynn, E. E., & Sharkey, K. M. (2020). Delayed sleep timing and circadian rhythms in pregnancy and transdiagnostic symptoms associated with postpartum depression. Translational Psychiatry, 10, 18.CrossRefGoogle ScholarPubMed
Okun, M. L., Kiewra, K., Luther, J. F., Wisniewski, S. R., & Wisner, K. L. (2011). Sleep disturbances in depressed and nondepressed pregnant women. Depression and Anxiety, 28, 676685.CrossRefGoogle ScholarPubMed
Ouyang, M., Hellman, K., Abel, T., & Thomas, S. A. (2004). Adrenergic signaling plays a critical role in the maintenance of waking and in the regulation of REM sleep. Journal of Neurophysiology, 92, 20712082. doi:10.1152/jn.00226.2004CrossRefGoogle Scholar
Paivio, S. C. (2001). Stability of retrospective self-reports of child abuse and neglect before and after therapy for child abuse issues. Child Abuse & Neglect, 25, 10531068. doi:10.1016/s0145-2134(01)00256-3CrossRefGoogle ScholarPubMed
Pien, G. W., & Schwab, R. J. (2004). Sleep disorders during pregnancy. Sleep, 27, 14051417. doi:10.1093/sleep/27.7.1405CrossRefGoogle ScholarPubMed
Qiu, C., Gelaye, B., Zhong, Q.-Y., Enquobahrie, D. A., Frederick, I. O., & Williams, M. A. (2016). Construct validity and factor structure of the Pittsburgh sleep quality index among pregnant women in a Pacific-northwest cohort. Sleep and Breathing, 20, 293301.CrossRefGoogle Scholar
Raniti, M. B., Waloszek, J. M., Schwartz, O., Allen, N. B., & Trinder, J. (2018). Factor structure and psychometric properties of the Pittsburgh sleep quality index in community-based adolescents. Sleep, 41, zsy066.CrossRefGoogle ScholarPubMed
Reuben, A., Moffitt, T. E., Caspi, A., Belsky, D. W., Harrington, H., Schroeder, F., … Danese, A. (2016). Lest we forget: Comparing retrospective and prospective assessments of adverse childhood experiences in the prediction of adult health. Journal of Child Psychology and Psychiatry, 57, 11031112.CrossRefGoogle ScholarPubMed
Romano, E., Zoccolillo, M., & Paquette, D. (2006). Histories of child maltreatment and psychiatric disorder in pregnant adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 45, 329336. doi:10.1097/01.chi.0000194563.40418.81CrossRefGoogle ScholarPubMed
Seng, J. S., Low, L. K., Sperlich, M., Ronis, D. L., & Liberzon, I. (2009). Prevalence, trauma history, and risk for posttraumatic stress disorder among nulliparous women in maternity care. Obstetrics & Gynecology, 114, 839847. doi:10.1097/AOG.0b013e3181b8f8a2CrossRefGoogle ScholarPubMed
Sharma, S. K., Nehra, A., Sinha, S., Soneja, M., Sunesh, K., Sreenivas, V., & Vedita, D. (2016). Sleep disorders in pregnancy and their association with pregnancy outcomes: A prospective observational study. Sleep and Breathing, 20, 8793. doi:10.1007/s11325-015-1188-9CrossRefGoogle ScholarPubMed
Shea, A. K., Streiner, D. L., Fleming, A., Kamath, M. V., Broad, K., & Steiner, M. (2007). The effect of depression, anxiety and early life trauma on the cortisol awakening response during pregnancy: Preliminary results. Psychoneuroendocrinology, 32, 10131020. doi:10.1016/j.psyneuen.2007.07.006CrossRefGoogle ScholarPubMed
Sheehan, C. M., Li, L., & Friedman, E. M. (2020). Quantity, timing, and type of childhood adversity and sleep quality in adulthood. Sleep Health, 6, 246252.CrossRefGoogle ScholarPubMed
Skouteris, H., Germano, C., Wertheim, E. H., Paxton, S. J., & Milgrom, J. (2008). Sleep quality and depression during pregnancy: A prospective study. Journal of Sleep Research, 17, 217220.CrossRefGoogle ScholarPubMed
Spertus, I. L., Yehuda, R., Wong, C. M., Halligan, S., & Seremetis, S. V. (2003). Childhood emotional abuse and neglect as predictors of psychological and physical symptoms in women presenting to a primary care practice. Child Abuse & Neglect, 27, 12471258.CrossRefGoogle ScholarPubMed
Spicer, J., Werner, E., Zhao, Y., Choi, C. W., Lopez-Pintado, S., Feng, T., … Monk, C. (2013). Ambulatory assessments of psychological and peripheral stress-markers predict birth outcomes in teen pregnancy. Journal of Psychosomatic Research, 75(4), 305313.CrossRefGoogle ScholarPubMed
Spinhoven, P., Penninx, B. W., Hickendorff, M., van Hemert, A. M., Bernstein, D. P., & Elzinga, B. M. (2014). Childhood trauma questionnaire: Factor structure, measurement invariance, and validity across emotional disorders. Psychological Assessment, 26, 717729. doi:10.1037/pas0000002CrossRefGoogle ScholarPubMed
Tanaka, M., Wekerle, C., Schmuck, M. L., Paglia-Boak, A., & Team, M. A. P. R. (2011). The linkages among childhood maltreatment, adolescent mental health, and self-compassion in child welfare adolescents. Child Abuse & Neglect, 35, 887898. doi:10.1016/j.chiabu.2011.07.003CrossRefGoogle ScholarPubMed
Treutiger, B.-M., & Lindberg, L. (2013). Prevention of depressive symptoms among adolescent girls. In Andershed, A.-K. (Ed.), Girls at risk: Swedish longitudinal research on adjustment (pp. 5778). New York, NY: Springer New York.CrossRefGoogle Scholar
U.S. Department of Health & Human Services & Administration on Children. (2020). Child maltreatment 2018. Retrieved from Scholar
Wang, Y., Raffeld, M. R., Slopen, N., Hale, L., & Dunn, E. C. (2016). Childhood adversity and insomnia in adolescence. Sleep Medicine, 21, 1218. doi:10.1016/j.sleep.2016.01.011CrossRefGoogle ScholarPubMed
Warland, J., Dorrian, J., Morrison, J. L., & O'Brien, L. M. (2018). Maternal sleep during pregnancy and poor fetal outcomes: A scoping review of the literature with meta-analysis. Sleep Medicine Reviews, 41, 197219.CrossRefGoogle ScholarPubMed
Wegman, H. L., & Stetler, C. (2009). A meta-analytic review of the effects of childhood abuse on medical outcomes in adulthood. Psychosomatic Medicine, 71, 805812. doi:10.1097/PSY.0b013e3181bb2b46CrossRefGoogle ScholarPubMed
Widom, C. S., Czaja, S. J., Bentley, T., & Johnson, M. S. (2012). A prospective investigation of physical health outcomes in abused and neglected children: New findings from a 30-year follow-up. American Journal of Public Health, 102, 11351144. doi:10.2105/AJPH.2011.300636CrossRefGoogle ScholarPubMed
Yali, A. M., & Lobel, M. (1999). Coping and distress in pregnancy: An investigation of medically high risk women. Journal of Psychosomatic Obstetrics & Gynecology, 20, 3952.CrossRefGoogle ScholarPubMed
Cited by

Save article to Kindle

To save this article to your Kindle, first ensure is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the or variations. ‘’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Associations between childhood maltreatment, poor sleep, and prenatal distress in pregnant adolescents
Available formats

Save article to Dropbox

To save this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about saving content to Dropbox.

Associations between childhood maltreatment, poor sleep, and prenatal distress in pregnant adolescents
Available formats

Save article to Google Drive

To save this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about saving content to Google Drive.

Associations between childhood maltreatment, poor sleep, and prenatal distress in pregnant adolescents
Available formats

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *