Adverse childhood experiences and adult inflammation: Findings from the 1958 British birth cohort

BACKGROUND The relationship between adverse childhood experiences (ACE) and poorer health across the life course is well established. Increased chronic inflammation might be one mechanism through which these associations operate. The aim of this study was to explore the relationship between ACE and adult inflammation using a prospective longitudinal study. We also investigated whether associations were explained by life course socioeconomic, psychological and health behavioural factors, and whether associations differed by gender. METHODS Multiply imputed data on 7464 participants of the National Child Development Study (1958 British birth cohort) were used. Prospectively collected data on ACE included care placement, physical neglect, parental separation, family history of offences, mental illness, domestic conflict and alcohol misuse across childhood (0-16 years). Adult inflammation was indicated by C-reactive protein (CRP), fibrinogen and Von Willebrand factor (vWF) at age 44/45. Multivariable linear regression models were used to estimate associations between ACE and adult inflammation. RESULTS Graded associations for ACE with CRP and fibrinogen were observed (e.g. CRP: 1 ACE: 4.61% higher, 95% CI: -3.13, 12.97; 2+ ACE: 16.35% higher, 95% CI: 6.87, 26.66). Socioeconomic and health behavioral factors were found to particularly explain these associations. After inclusion of all covariates associations between ACE and mid-life inflammation were no longer significant. Associations did not differ for men and women. CONCLUSIONS ACE were associated in a graded manner with adult inflammation in a British birth cohort. The association was explained by life course socioeconomic and health behavioral factors, in particular. This study highlights the importance of protecting children from ACE and its negative health effects, and in supporting children through education and into skilled, secure work.