The perinatal self-care index: development of an evidence-based assessment tool for use with child sexual abuse survivors.

Every ninth woman presenting for prenatal care reports having experienced childhood sexual abuse. Many develop mental health disorders, including posttraumatic stress disorder (PTSD). In response to PTSD, pregnant women survivors of childhood sexual abuse engage in negative perinatal self-care behaviors that can lead to adverse perinatal outcomes. Currently, promotion of perinatal self-care does not consider childhood sexual abuse or PTSD. This study aimed to develop a Perinatal Self-Care Index, determine sensitivity of the index to differences in behaviors of childhood sexual abuse survivors (PTSD-affected and PTSD-resilient), and validate usefulness in relation to birth weight. Secondary analysis was conducted using data from a prospective cohort study of the effects of PTSD on pregnancy outcomes. The index explained 6.5% of variance in birth weight. Prediction improved to 9.4% once PTSD and socioeconomic status were considered. The index is sensitive to differences in PTSD-affected versus PTSD-resilient survivors of childhood sexual abuse and a useful predictor of birth weight in this analysis.