Hospitalisation patterns among children exposed to childhood adversity: a population-based cohort study of half a million children

Abstract

Background Children who are exposed to adversities might be more susceptible to disease development during childhood and in later life due to impaired physiological and mental development. To explore this hypothesis, we assessed hospitalisation patterns through childhood and into adult life among those exposed to different trajectories of adversities during childhood.Methods For this population-based cohort study, we used annually updated data from Danish nationwide registers covering more than half a million children (aged 0-15 years) born between 1994 and 2001. Children who were alive and resident in Denmark on their 16th birthday were included in the analysis. Cluster analysis was used to divide children into five distinct trajectories according to their experience of childhood adversities, including poverty and material deprivation, loss or threat of loss within the family, and aspects of family dynamics. To describe comprehensively the disease patterns experienced by these groups of children, we assessed the associations of each adversity trajectory with hospital admission patterns according to the entire spectrum of disease diagnoses in the International Classification of Diseases 10th edition, from birth to 24 years of age, using survival models.

Identifying adverse childhood experiences with electronic health records of linked mothers and children in England: a multistage development and validation study

“…Therefore, our findings complement population-level reports from the Danish Life Course Cohort Study, which used datadriven approaches (eg, trajectory analyses) to group individuals into higher and lower adversity groups. 86,87 Our prevalence estimate for any child maltreatment or maternal IPV (3%) is over ten times higher than previous estimates in nationwide studies of hospital admissions (eg, <0•1%), 19 and higher than previous studies using primary care data (eg, 1•8% for child maltreatment). 88 Estimates for the more prevalent ACEs, such as maternal substance misuse and maternal mental health problems, were also higher than previous primary care studies assessing mothers or children in isolation.…”

Adverse childhood experiences and global mental health: avenues to reduce the burden of child and adolescent mental disorders

“…Research highlights how exposure to ACEs is associated with a higher prevalence of mental disorders (e.g. PTSD, anxiety, depressive and conduct disorders) in childhood and adolescence that may persist into adulthood (Hughes et al ., 2017 ; Baldwin et al ., 2021 ; Rod et al ., 2021 ). A systematic review and meta-analysis on the effects of multiple ACEs on health including 37 studies and a total of 253 719 participants, for example, reported how having multiple ACEs (up to age 16–18) is a major risk factor for several health conditions.…”

Evolution, the Immune System, and the Health Consequences of Socioeconomic Inequality

“…Many effects of low SES on the composition of the microbiota are difficult to disentangle from the effects of stress, but it is clear that childhood adversity is associated with increased mortality in later life ( 180 ), and it is likely that the microbiota is involved. For example, separating rat pups from their mothers in the neonatal period had long-term effects on the biodiversity of their microbiomes that persisted into adulthood ( 164 ), and stressing adult rodents also causes an altered microbiome ( 181 ).…”