Early life adversity exposure and circulating markers of inflammation in children and adolescents: A systematic review and meta-analysis
The Early Intervention Foundation
Tuesday, September 29, 2020
The ACEs study was not the first to observe a connection between child maltreatment and poor mental health outcomes. However, it was one of the first studies to observe that a link also existed between ACEs and poor adult physical health.
Early life adversity exposure and circulating markers of inflammation in children and adolescents: A systematic review and meta-analysis
Authors: KR Kuhlman, SR Horn, JJ Chiang and JE Bower
Published by: Brain, Behavior and Immunity, 2020
The ACE study authors originally assumed that this link might be explained by health harming behaviours (for example, smoking, drinking and using illicit drugs) used by those who have experienced ACEs to cope with the trauma.
Researchers have since suggested that the relationship between ACEs and poor physical health might also be explained by high levels of trauma-related stress (also known as “toxic” stress) that exert wear and tear on the immune system over time. Researchers have identified a number of biomarkers, such as chronic inflammation, that may be indicative of this stress-related wear and tear.
Studies show that chronic inflammation is a reliable precursor of cancer and cardiovascular disease, and is also present in adults who have retrospectively reported a higher number of ACEs. The researchers therefore wanted to test whether inflammatory biomarkers were present in children who experienced a high number of ACEs.
Study aims
This study investigated the relationship between inflammatory biomarkers and children’s exposure to ACEs through a systematic review of 13 studies that prospectively collected information on stress-related biomarkers through blood and saliva samples at regular intervals through children’s development.
This information was then compared to information about their exposure to child maltreatment and other adversities that was also collected at these assessments.
Key findings
This study failed to find any significant relationship between elevated levels of chronic inflammation and children’s history of ACEs.
Implications for practice
- The authors acknowledge that the lack of findings was a surprise, given consistent adult evidence linking stress biomarkers to life-threatening diseases and retrospective evidence of ACE history. They speculate that this finding may have been due to the relatively small number of studies identified and discrepancies in their methodologies.
- However, this finding is consistent with a growing body of evidence from other prospective studies showing that the link between ACEs and physical health is much weaker than what was originally suggested by the first ACE study.
- Some have therefore suggested that poverty and other socio-economic factors, which co-occur with ACEs and health inequalities, may better explain the link between ACEs and poor adult outcomes, as the ACE authors originally assumed.
- The Early Intervention Foundation is a What Works Centre that champions and supports the use of effective early intervention to improve the lives of children and young people at risk of experiencing poor outcomes
- Read more in the Adverse Childhood Experiences Special Report