Exposure to abuse and changes in cardiometabolic risk profiles over 3 years in young South African women

South African women experience high rates of abuse and cardiometabolic diseases, but research on their relationship is less investigated. This study examined the associations of exposure to abuse in childhood and adulthood with cardiometabolic risk factors [body mass index (BMI), waist circumference (WC), systolic (SBP) and diastolic blood pressure (DBP), total cholesterol (TC), HbA1c] over three years among women aged 18–40 years. The longitudinal Rape Impact Cohort Evaluation (RICE) study, conducted between 2014 and 2019, examined the associations of self-reported exposures to childhood abuse (CA) (any, sexual, physical, emotional CA and parental neglect < 18 years of age), lifetime intimate partner violence (IPV) (any, sexual, physical, emotional and economic IPV) and lifetime non-partner rape with cardiometabolic outcomes. These were explored using linear mixed-effects models, with the inclusion of the interaction terms, (1) ‘abuse/trauma*rape-exposed’; (2) ‘abuse/trauma*baseline-rape exposure*time’ to account for potential effects of baseline rape-exposure or time. Cardiometabolic data were collected at baseline (N = 1617; mean age 25.3 years), 12 (N = 1178), 24 (N = 925) and 36 months (N = 571). Exposures to any CA (β = 0.79; se = 0.27; p = 0.003), physical CA (β = 0.68; se = 0.27; p = 0.013) and greater frequency of physical CA (β = 0.73; se = 0.36; p = 0.042) were associated with rising BMI over 3 years of follow-up. There was no evidence of significant effects between baseline-rape exposure or time and most CA types in the associations examined (p > 0.05 for all interaction tests). An exception was found for sexual CA, where baseline-rape exposure influenced its association with WC (p = 0.010 for the interaction test). Time also affected the associations of emotional CA with both WC and BMI (ps ≤ 0.039 for the interaction tests). Exposures to IPV or lifetime non-partner rape were not significantly associated with increased changes in any cardiometabolic variables investigated, and no effects of baseline rape-exposure or time. This prospective analysis demonstrated that childhood abuse experiences were associated with increased BMI levels over 3 years of follow-up in young South African women. Further research over a longer period is required to clearly delineate the effect of abuse exposure on cardiometabolic diseases.