Exposure to traumatic and stressful childhood events, known as adverse childhood experiences (ACEs), are associated with childhood atopic dermatitis (AD) across time, with children who experienced a higher number of ACEs having a higher prevalence of AD, according to findings published in Dermatitis.
To determine the association between ACEs and AD in childhood, investigators analyzed data from the Fragile Families and Child Wellbeing Study, a longitudinal prospective birth cohort study following 4898 women and their children across 20 large US cities. To determine AD prevalence at ages 5, 9, and 15, multivariable weighted logistic regression models were constructed, adjusting for sociodemographics. Childhood abuse (physical abuse, emotional abuse, sexual abuse and neglect) and household dysfunction (depression, maternal drug use, parental incarceration, parental separation/divorce) were evaluated.
Compared with children at age 5 years who did not have ACE exposures, children at age 5 years who experienced 1 ACE (adjusted odds ratio [aOR], 1.42; 95% CI, 1.08-1.86), 2 ACEs (aOR, 1.49; 95% CI, 1.10-2.02), or 3 or more ACEs (aOR, 2.10; 95% CI, 1.52-2.89) had significantly increased odds of AD in the past year, with 3 or more having the highest effect size. At age 9 years, only 3 or more ACE exposures significantly increased the odds of AD in the past year (aOR, 1.48; 95% CI, 1.09-2.01). By age 15, there were no longer any significant associations between ACE exposures and past year AD. In regard to AD course, children exposed to more than 1 ACE in multiple follow-up periods were more likely to experience early-onset intermittent AD (aOR, 3.02; 95% CI, 1.13-8.11) and early-onset persistent AD (aOR, 2.65; 95% CI, 1.37-5.12).
The study investigators concluded, “The clinical relevance of these findings should prompt health professionals to consider using screening tools that identify ACEs in pediatric populations. Furthermore, interventions aimed at preventing ACEs or addressing current issues may mitigate risk for AD occurrence and persistence. Future research is needed to confirm these associations, determine their mechanism(s), and identify optimal prevention and treatment strategies in this subset of AD patients.”
McKenzie C, Silverberg JI. Association of adverse childhood experiences with childhood atopic dermatitis in the United States. Dermatitis. 2020;31(2):147–152.