Center on the Developing Child, Harvard University, Cambridge, MA; Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA.
Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY.
J Pediatr. 2014 Mar;164(3):631-8.e1-2. doi: 10.1016/j.jpeds.2013.11.003. Epub 2013 Dec 15.
To examine whether and when effects of cumulative adversity in the first 7 years of life are evident in relation to 3 childhood markers of risk for poor adult physical health.
The study data are from an English birth cohort. Parental reports of 8 social risk factors were obtained during the child's first 7 years, and scores were created to reflect cumulative adversity at 4 developmental periods. At age 7 and 11 years, weight, height, and blood pressure (BP) were measured by clinic staff, and caregivers reported behavior problems. Linear regression was used to estimate associations of cumulative adversity with each outcome (n = 4361) and changes in these outcomes between 7 and 11 years (n = 3348).
At age 7 years, mean adversity and chronic exposure to high adversity were associated with elevated body mass index (BMI) and internalizing and externalizing symptoms (P < .05), but not elevated BP. Adversity in all developmental periods was associated with elevated numbers of internalizing and externalizing symptoms (P < .0001), but associations were less robust for BMI. Adversity did not predict change in BMI or BP between age 7 and 11 years, however, it predicted increases in internalizing and externalizing symptoms (P < .0001).
Cumulative adversity was associated with BMI and behavior problems at age 7 years, and our data indicate that timing and chronicity of exposure to adversity differentially influence diverse indicators of long-term health risk commonly measured in childhood. This research suggests the hypothesis that interventions to address adversity could reduce the development of multiple chronic disease risk factors and limit their effects on health.
探讨生命最初 7 年累积逆境的影响是否以及何时在与 3 项儿童期成年身体健康不良风险指标相关时显现。
本研究的数据来自英国出生队列。在儿童生命最初 7 年期间，父母报告了 8 种社会风险因素，为反映 4 个发育时期的累积逆境，为每个时期都创建了评分。在 7 岁和 11 岁时，由临床工作人员测量体重、身高和血压（BP），并由照顾者报告行为问题。线性回归用于估计累积逆境与每个结局（n=4361）以及 7 至 11 岁之间这些结局变化（n=3348）的关联。
在 7 岁时，平均逆境和长期高逆境暴露与体重指数（BMI）和内化和外化症状升高有关（P<.05），但与 BP 升高无关。所有发育时期的逆境均与内化和外化症状数量增加有关（P<.0001），但与 BMI 的关联不太稳健。然而，逆境并未预测 BMI 或 BP 在 7 至 11 岁之间的变化，却预测了内化和外化症状的增加（P<.0001）。
累积逆境与 7 岁时的 BMI 和行为问题有关，我们的数据表明，逆境暴露的时间和慢性对多种儿童期常用的长期健康风险指标有不同的影响。这项研究提出了一个假设，即干预措施可以减少多种慢性疾病风险因素的发展，并限制其对健康的影响。
