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Associations between duration of first trimester intrauterine exposure to genocide against the Tutsi and health outcomes in adulthood
Authors:Glorieuse Uwizeye  Julienne N Rutherford  Zaneta M Thayer
Institution:1. Arthur Labatt Family School of Nursing, Western University, London, Ontario, Canada;2. Biobehavioral Health Sciences Division, College of Nursing, University of Arizona, Tucson, Arizona, USA

Contribution: Conceptualization (equal), Data curation (supporting), Formal analysis (supporting), Funding acquisition (supporting), Methodology (equal), Visualization (equal), Writing - original draft (equal), Writing - review & editing (equal);3. Department of Anthropology, Dartmouth College, Hanover, New Hampshire, USA

Abstract:

Objectives

Hundreds of thousands of Rwandans were conceived during the 1994 genocide against the Tutsi, including thousands conceived by genocidal rape. We explore whether the duration of first trimester exposure to the genocide is associated with variation in adult mental health outcomes in individuals exposed to varying degrees of genocide-related stress in utero.

Materials and Methods

We recruited 30 Rwandans conceived via genocidal rape, 31 Rwandans conceived by genocide survivors not raped, and 30 individuals of Rwandan-descent who were conceived outside of Rwanda at the time of the genocide (control group). Individuals were age- and sex-matched across groups. Adult mental health was assessed through standardized questionnaires for vitality, anxiety, and depression.

Results

Among the genocide only group, a longer duration of first trimester prenatal exposure was associated with higher anxiety scores and lower vitality (both p < 0.010), and higher depression scores (p = 0.051). Duration of first trimester exposure was not associated with any measures of mental health among the genocidal rape or control group.

Discussion

Duration of exposure to genocide in the first trimester of gestation was associated with variation in adult mental health among the genocide only group. The lack of association between duration of first trimester exposure to genocide and adult mental health in the genocidal rape group may reflect the fact that stress associated with conception through rape persisted beyond the genocide period itself, encompassing all of gestation and likely beyond. Geopolitical and community interventions are needed in the context of extreme events during pregnancy to mitigate adverse intergenerational outcomes.
Keywords:anxiety  depression  developmental origins of health and disease  first trimester  prenatal stress exposure  vitality
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