Childhood sexual abuse, girls' genitourinary diseases, and psychiatric comorbidity: A matched-cohort study.

Objective: The present study aimed to determine whether psychiatric comorbidity (i.e., diagnostic comorbidity in eight categories of mental and behavioral disorders) mediates the relationship between childhood sexual abuse (CSA) and diseases of the genitourinary system (International Statistical Classification of Diseases and Related Health Problems, 10th revision) among girls. Method: Using a prospective matched-cohort design, we documented diagnoses given by a physician after a medical consultation or hospitalization for diseases of the genitourinary system, for 661 sexually abused girls and 661 matched controls via administrative databases covering the period between January 1996 and March 2013. Path analyses using negative binomial regressions with CSA as independent variable, psychiatric comorbidity as mediator and genitourinary diseases diagnoses as dependent variables were performed. Results: After controlling for socioeconomic level, prior genitourinary diseases and number of years of medical data, the mediation effect for the path from CSA to genitourinary diseases through psychiatric comorbidity was significant for the urinary system (b = .125, 95% confidence interval [0.057, 0.192]) as well as for the genital system (b = .213, 95% confidence interval [0.141, 0.285]). Psychiatric comorbidity carried 62% of the sexual abuse total effect on the number of diagnoses received for genital diseases, whereas it carried 23% of the sexual abuse total effect on the number of diagnoses received for urinary diseases. Conclusions: Findings suggest that CSA may have an indirect effect on girls' diagnosed genitourinary diseases during a medical consultation or hospitalization through the increased risk for psychiatric comorbidity. Early interventions aimed at addressing psychological distress among sexually abused girls might prevent the emergence of genitourinary diseases years after the abuse. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

A Matched Cohort Study of the Association Between Childhood Sexual Abuse and Teenage Pregnancy.

PURPOSE: This matched cohort study aims to determine whether teenagers with a history of childhood sexual abuse (CSA) are at greater risk of consulting for a pregnancy and related complications than teenagers from the general population. It also aims to compare provoked abortion, live births, and fetal losses of participants who were sexually abused in childhood and those of the general population. METHODS: A total of 661 girls (aged 13-18 years) with a corroborated by Child Protection Services CSA report between 2001 and 2010 were matched to 661 girls from the general population upon age, biological sex, urban Child Protection Services area, and public drug insurance admissibility at reporting date. Pregnancy consultations and complications during pregnancy and delivery were documented using diagnoses from public health insurance administrative databases from January 1996 to March 2013. Socioeconomic status was controlled. RESULTS: Results indicate that compared with participants from the general population, those with a history of CSA were 4.6 times more likely to consult for at least one pregnancy, 5.3 times more likely to consult for at least one complication during pregnancy or delivery, and on average 5.2 and 3.3 times more likely to consult for at least one live birth and provoked abortion, respectively. There were too few observations to compare fetal losses between groups. CONCLUSIONS: Medical interventions for teenage pregnancies and related complications should take into consideration a possible history of CSA to reinforce gynecological follow-up and treatment for girls who were sexually abused and to prevent unfavorable outcomes.

Integrating bioassays and analytical chemistry as an improved approach to support safety assessment of food contact materials.

Food contact materials (FCM) contain chemicals which can migrate into food and result in human exposure. Although it is mandatory to ensure that migration does not endanger human health, there is still no consensus on how to pragmatically assess the safety of FCM since traditional approaches would require extensive toxicological and analytical testing which are expensive and time consuming. Recently, the combination of bioassays, analytical chemistry and risk assessment has been promoted as a new paradigm to identify toxicologically relevant molecules and address safety issues. However, there has been debate on the actual value of bioassays in that framework. In the present work, a FCM anticipated to release the endocrine active chemical 4-nonyphenol (4NP) was used as a model. In a migration study, the leaching of 4NP was confirmed by LC-MS/MS and GC-MS. This was correlated with an increase in both estrogenic and anti-androgenic activities as measured with bioassays. A standard risk assessment indicated that according to the food intake scenario applied, the level of 4NP measured was lower, close or slightly above the acceptable daily intake. Altogether these results show that bioassays could reveal the presence of an endocrine active chemical in a real-case FCM migration study. The levels reported were relevant for safety assessment. In addition, this work also highlighted that bioactivity measured in migrate does not necessarily represent a safety issue. In conclusion, together with analytics, bioassays contribute to identify toxicologically relevant molecules leaching from FCM and enable improved safety assessment.