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Open Access 01-12-2018 | Research article

Systematic review of pediatric health outcomes associated with childhood adversity

Authors: Debora Lee Oh, Petra Jerman, Sara Silvério Marques, Kadiatou Koita, Sukhdip Kaur Purewal Boparai, Nadine Burke Harris, Monica Bucci

Published in: BMC Pediatrics | Issue 1/2018

Abstract

Background

Early detection of and intervention in childhood adversity has powerful potential to improve the health and well-being of children. A systematic review was conducted to better understand the pediatric health outcomes associated with childhood adversity.

Methods

PubMed, PsycArticles, and CINAHL were searched for relevant articles. Longitudinal studies examining various adverse childhood experiences and biological health outcomes occurring prior to age 20 were selected. Mental and behavioral health outcomes were excluded, as were physical health outcomes that were a direct result of adversity (i.e. abusive head trauma). Data were extracted and risk of bias was assessed by 2 independent reviewers.

Results

After identifying 15940 records, 35 studies were included in this review. Selected studies indicated that exposure to childhood adversity was associated with delays in cognitive development, asthma, infection, somatic complaints, and sleep disruption. Studies on household dysfunction reported an effect on weight during early childhood, and studies on maltreatment reported an effect on weight during adolescence. Maternal mental health issues were associated with elevated cortisol levels, and maltreatment was associated with blunted cortisol levels in childhood. Furthermore, exposure to childhood adversity was associated with alterations of immune and inflammatory response and stress-related accelerated telomere erosion.

Conclusion

Childhood adversity affects brain development and multiple body systems, and the physiologic manifestations can be detectable in childhood. A history of childhood adversity should be considered in the differential diagnosis of developmental delay, asthma, recurrent infections requiring hospitalization, somatic complaints, and sleep disruption. The variability in children’s response to adversity suggests complex underlying mechanisms and poses a challenge in the development of uniform diagnostic guidelines. More large longitudinal studies are needed to better understand how adversity, its timing and severity, and the presence of individual genetic, epigenetic, and protective factors affects children’s health and development.

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Title: Systematic review of pediatric health outcomes associated with childhood adversity
Authors: Debora Lee Oh
Petra Jerman
Sara Silvério Marques
Kadiatou Koita
Sukhdip Kaur Purewal Boparai
Nadine Burke Harris
Monica Bucci
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: BMC Pediatrics / Issue 1/2018
Electronic ISSN: 1471-2431
DOI: https://doi.org/10.1186/s12887-018-1037-7

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Systematic review of pediatric health outcomes associated with childhood adversity

Abstract

Background

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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