Am J Epidemiol. 2022 Jan 1;191(1):38-48. doi: 10.1093/aje/kwab236.
Emerging evidence suggests that trauma experienced in childhood has negative transgenerational implications for offspring mental and physical health. We aimed to investigate whether early-life adversity experienced as bereavement is associated with chronic inflammatory health in offspring. The study population included 3 generations of Swedish families with a base population of 453,516 children (generation 3) born in 2001-2012. Exposure was defined as the middle generation's (generation 2) experiencing bereavement in childhood due to the death of a parent (generation 1). Outcomes in generation 3 included 2 diagnoses of inflammatory diseases, including asthma, allergic diseases, eczema, and autoimmune diseases. Survival analysis was used to identify causal pathways, including investigation of mediation by generation 2 mood disorders and socioeconomic status (SES). We found that early-life bereavement experienced by women was associated with early-onset offspring asthma (hazard ratio = 1.15, 95% confidence interval: 1.08, 1.23); mediation analysis revealed that 28%-33% of the association may be mediated by SES and 9%-20% by mood disorders. Early-life bereavement experienced by men was associated with autoimmune diseases in offspring (hazard ratio = 1.31, 95% confidence interval: 1.06, 1.62), with no evidence of mediation. In conclusion, adversity experienced early in life may contribute to an increased risk of inflammatory diseases which is partly mediated by mood disorders and SES.
新的证据表明,儿童时期经历的创伤对后代的精神和身体健康具有代际负面影响。我们旨在研究丧亲之痛等早期生活逆境是否与后代的慢性炎症健康有关。该研究人群包括三代瑞典家庭,基础人群为 1981 年至 2012 年期间出生的 453516 名儿童(第 3 代)。暴露定义为中间一代(第 2 代)在童年时期因父母一方(第 1 代)去世而经历丧亲之痛。第 3 代的结果包括 2 种炎症性疾病的诊断,包括哮喘、过敏疾病、湿疹和自身免疫性疾病。生存分析用于确定因果途径,包括调查第 2 代情绪障碍和社会经济地位(SES)的中介作用。我们发现,女性早期丧亲之痛与后代早期哮喘有关(危险比=1.15,95%置信区间:1.08,1.23);中介分析表明,该关联的 28%-33%可能由 SES 介导,9%-20%可能由情绪障碍介导。男性早期丧亲之痛与后代自身免疫性疾病有关(危险比=1.31,95%置信区间:1.06,1.62),无中介作用的证据。总之,生命早期的逆境可能会导致炎症性疾病的风险增加,其中部分原因是情绪障碍和 SES 所致。