From the Department of Dermatology, Northwestern University Feinberg School of Medicine.
Department of Dermatology, George Washington University School of Medicine and Health Sciences, Washington, DC.
Dermatitis. 2020 Mar/Apr;31(2):147-152. doi: 10.1097/DER.0000000000000550.
Traumatic and stressful events of childhood, known as adverse childhood experiences (ACEs), have been associated with numerous health outcomes. However, little is known about ACEs in atopic dermatitis (AD) patients. We sought to determine the relationship between ACEs and childhood AD. Data were analyzed from the Fragile Families and Child Wellbeing Study, a longitudinal birth cohort study that followed 4898 women and their children born in large US cities. Multivariable weighted logistic regression models adjusting for sociodemographics were constructed to determine the associations of ACEs with AD prevalence at ages 5, 9, and 15 years. Children who experienced 1 ACE (multivariable logistic regression; adjusted odds ratio [aOR], 1.42; 95% confidence interval [CI], 1.08-1.86), 2 ACEs (1.49; 95% CI, 1.10-2.02), or 3 or more ACEs (2.10; 95% CI, 1.52-2.89) had significantly increased odds of AD history compared with children without ACEs at age 5 years. Children who experienced 3 or more ACEs (1.48; 95% CI, 1.09-2.01) had significantly increased odds of AD history compared with children without ACEs at age 9 years. There were no significant associations between ACEs and history of AD at age 15 years. In conclusion, ACE exposures are related to childhood AD across time. Children who experience a greater number of ACEs have higher prevalence of AD.
儿童时期的创伤和压力事件,即不良儿童经历 (ACEs),与许多健康结果有关。然而,关于特应性皮炎 (AD) 患者的 ACEs 知之甚少。我们旨在确定 ACEs 与儿童 AD 之间的关系。本研究的数据来自脆弱家庭与儿童健康研究( Fragile Families and Child Wellbeing Study),这是一项在美国大城市中对 4898 名妇女及其子女进行的纵向出生队列研究。构建了多变量加权逻辑回归模型,以调整社会人口统计学因素来确定 ACEs 与 5 岁、9 岁和 15 岁时 AD 患病率之间的关系。与无 ACEs 的儿童相比,经历 1 次 ACE(多变量逻辑回归;调整后的优势比 [aOR],1.42;95%置信区间 [CI],1.08-1.86)、2 次 ACE(1.49;95% CI,1.10-2.02)或 3 次或更多 ACEs(2.10;95% CI,1.52-2.89)的儿童患 AD 的几率显著增加。与无 ACEs 的儿童相比,经历 3 次或更多 ACEs 的儿童在 9 岁时患 AD 的几率更高(1.48;95% CI,1.09-2.01)。在 15 岁时,ACEs 与 AD 病史之间没有显著关联。总之,ACE 暴露与儿童时期的 AD 随时间变化相关。经历更多 ACEs 的儿童 AD 患病率更高。