Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA.
Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA.
Pediatr Res. 2021 Jan;89(2):368-376. doi: 10.1038/s41390-020-01290-9. Epub 2020 Dec 7.
This review begins with a brief summary of the importance of child maltreatment as a major public health problem, given its prevalence and the substantial human and economic costs involved. The focus then shifts to consideration of personalized medicine and child maltreatment, including genetic and genomics factors, as well as the role of social determinants of health. Research on epigenetics related to child abuse and neglect is presented, followed by that pertaining to a few specific social factors, such as poverty, parental depression and substance use, and domestic (or intimate partner) violence. The review ends with a discussion of interventions to help address social determinants of health with brief descriptions of several model programs, and thoughts concerning the role of personalized medicine in addressing child maltreatment in the foreseeable future. IMPACT: This paper synthesizes knowledge on social determinants of health and advances in genetics and genomics related to the prevention of child maltreatment. It provides examples of model approaches to addressing the prevention of child maltreatment in primary care practices.
本综述首先简要总结了儿童虐待作为一个主要公共卫生问题的重要性，因为它的普遍性以及所涉及的巨大人力和经济成本。然后，重点转向考虑个性化医学和儿童虐待，包括遗传和基因组因素，以及健康的社会决定因素的作用。介绍了与虐待和忽视儿童有关的表观遗传学研究，接着介绍了一些特定社会因素的研究，如贫困、父母抑郁和物质使用以及家庭（或亲密伴侣）暴力。本文最后讨论了干预措施，以帮助解决健康的社会决定因素，并简要介绍了几个示范方案，以及考虑个性化医学在可预见的未来解决儿童虐待问题中的作用。影响：本文综合了与预防儿童虐待相关的健康的社会决定因素和遗传学及基因组学方面的知识。它提供了一些针对初级保健实践中预防儿童虐待的模式方法的示例。
