Adverse Childhood Experiences and Child Development Outcomes in Ceará, Brazil: A Population-based Study

Rocha, Hermano Alexandre Lima; Sudfeld, Christopher R.; Leite, Álvaro Jorge Madeiro; Rocha, Sabrina Gabriele Maia Oliveira; Machado, Márcia Maria Tavares; Campos, Jocileide Sales; Silva, Anamaria C. e; Correia, Luciano Lima

doi:10.1016/j.amepre.2020.08.012

Cited by 22 publications

(15 citation statements)

References 37 publications

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“…Of note, food insecurity is associated with poorer mental health and may be a contributor in our study (15) . Food insecurity and MMD can negatively impact child nutritional status, parenting, and child development and represent an unprecedented risk to children's health and well-being (16)(17)(18)(19)(20)(21) .…”

Section: Discussionmentioning

confidence: 99%

Coronavirus disease 2019, food security and maternal mental health in Ceará, Brazil: a repeated cross-sectional survey

Rocha

Sudfeld

Leite

et al. 2021

Public Health Nutr.

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Objective To quantify the change in the risk of food insecurity and maternal mental disorder (MMD) before and during the COVID-19 pandemic. Design Repeated cross-sectional survey. Between July 17 and September 10, 2020, mother-child pairs who were enrolled in a population-based survey in 2017 were re-contacted by telephone for consent and to complete a telephonic COVID-19 survey. We used the Brazilian Food Insecurity Scale to assess food security and the Self Reporting Questionnaire (SRQ-20) to assess maternal mental disorders. McNemar’s test for paired data that also accounted for clustering was used. Logistic regression was used to assess the relationship of unemployment and receipt of government assistance with food insecurity and MMD in 2020. Setting Ceará, Brazil. Participants 577 mother-child pairs who completed the 2017 and 2020 surveys. At the time of the 2020 interview, the child cohort was 36-108 months of age. Results The proportion of mothers reporting food insecurity was 15.5% higher (95% CI: (5.9 – 25.1), p-value < 0.001) during the pandemic in July-August 2020 as compared to November 2017, while the prevalence of MMD was 40.2% higher during the pandemic (95% CI: 32.6 – 47.8, p-value < 0.001). Loss of formal employment was associated with increased risk of food insecurity, but not with the risk of MMD. Conclusions The risk of food insecurity and MMD in Ceará increased during the COVID-19 pandemic. These findings highlight the need for policies and interventions to reduce the impact of the COVID-19 pandemic on maternal and child health, nutrition, and well-being in Brazil.

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Section: Discussionmentioning

confidence: 99%

Coronavirus disease 2019, food security and maternal mental health in Ceará, Brazil: a repeated cross-sectional survey

Rocha

Sudfeld

Leite

et al. 2021

Public Health Nutr.

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“…More on the evaluated ACEs can be found elsewhere. 15 In each household, information was obtained about all children through the mother or primary caregiver report and also confirmed with the child health booklet held by the family. When maternal report and the booklet data were not in agreement, the health booklet data were preferentially considered.…”

Section: Methodsmentioning

confidence: 99%

“…The World Health Organization's Nurturing Care Framework for Early Childhood Development and literature report multiple factors to be associated with suboptimal development, including poverty, low maternal education, toxic stress exposure, low birth weight, poor child growth, and suboptimal breastfeeding, besides inadequate nutrition. 4 , 13 , 14 , 15 , 16 However, few large, population-based studies have examined the relationship of nutritional risk factors with child development outcomes, particularly in the context of rough climates regions such as Ceará and studies that evaluated the effect of undernutrition on the development of Brazilian children under 5 years of age are exceedingly rare. Although the prevalence of child undernutrition has dramatically declined, in Semiarid climatic regions as Ceará, it may have persisted, as this type of climate has been associated in different parts of the world with an increased risk of food insecurity, which in turn is associated with child malnutrition.…”

Section: Introductionmentioning

confidence: 99%

Undernutrition and short duration of breastfeeding association with child development: a population-based study

Rocha¹,

Correia²,

Leite³

et al. 2022

Jornal de Pediatria

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“…The seminal adverse childhood experiences (ACEs) studies which retrospectively assessed multiple early adversities found positive associations between cumulative adversities experienced during childhood with a range of adverse adult health outcomes [7][8][9][10] , many of which are the biggest contributors to the global burden of diseases 11 . In children, cumulative adversities are predictive of brain functioning 12 , general cognitive ability [13][14][15] , executive functioning 14,16 , social-emotional outcomes 17,18 , and several psychopathologies in adolescence 19,20 . This epidemiological evidence is supported by neuroscientific findings linking early adversities with structural and functional impairments in developing brain networks [21][22][23] .…”

Section: Introductionmentioning

confidence: 99%

The effect of cumulative early life adversities, and their differential mediation through hair cortisol levels, on childhood growth and cognition: Three-year follow-up of a birth cohort in rural India

Mukherjee

Bhopal²,

Bhavnani³

et al. 2022

Wellcome Open Res

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Background: Early adversities negatively impact children’s growth and development, putatively mediated by chronic physiological stress resulting from these adverse experiences. We aimed to estimate the associations between prospectively measured cumulative early adversities with growth and cognition outcomes in rural Indian preschool children and to explore if hair cortisol concentration (HCC), a measure of chronic physiological stress, mediated the above association. Methods: Participants were recruited from the SPRING cRCT in rural Haryana, India. Adversities experienced through pregnancy and the first year of life were measured in 1304 children at 12-months. HCC was measured at 12-months in 845 of them. Outcome measures were height-for-age-z-score (HAZ), weight-for-age-z-score (WAZ) and cognition, measured in 1124 children followed up at 3-years. Cognition was measured using a validated tablet-based gamified tool named DEEP. Results: Cumulative adversities at 12-months were inversely associated with all outcomes measures at 3-years. Each unit increase in adversity score led to a decrease of 0·08 units [95% confidence interval (CI):-0·11,-0·06] in DEEP-z-score; 0·12 units [-0·14,-0·09] in HAZ and 0·11 units [-0·13,-0·09] in WAZ. 12-month HCC was inversely associated with DEEP-z-score (-0·09 [-0·16,-0·01]) and HAZ (-0·12 [-0·20,-0·04]), but the association with WAZ was not significant (p = 0·142). HCC marginally mediated the association between cumulative adversities and HAZ (proportion mediated = 0·06, p = 0·014). No evidence of mediation was found for the cognition outcome. Conclusions: Cumulative early adversities and HCC measured at 12-months have persistent negative effects on child growth and cognition at 3-years. The association between adversities and these two child outcomes were differentially mediated by HCC, with no evidence of mediation observed for the cognitive outcome. Future studies should focus on other stress biomarkers, and alternate pathways such as the immune, inflammation and cellular ageing pathways, to unpack key mechanisms underlying the established relationship between early adversities and poor child outcomes.

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Adverse Childhood Experiences and Child Development Outcomes in Ceará, Brazil: A Population-based Study

Cited by 22 publications

References 37 publications

Coronavirus disease 2019, food security and maternal mental health in Ceará, Brazil: a repeated cross-sectional survey

Coronavirus disease 2019, food security and maternal mental health in Ceará, Brazil: a repeated cross-sectional survey

Undernutrition and short duration of breastfeeding association with child development: a population-based study

The effect of cumulative early life adversities, and their differential mediation through hair cortisol levels, on childhood growth and cognition: Three-year follow-up of a birth cohort in rural India

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