Maternal care and child physical health: impact of the exposure to adverse experiences during the first year of life of vulnerable children
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Universidade Federal de Minas Gerais
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Introduction: Adverse childhood experiences (ACEs) can negatively affect children'scurrent and future health.Objectives: This study aims to analyse the impact of ACE on the health of 12-month old infants assessed by a Physical Health and Maternal Care Indicator (ISCM).Methods: We conducted a retrospective cohort including 170 infants born in two public services for high-risk births in Brazil. ISCM gathers information that reflects maternal care and the child's health throughout the first year of life, such as vaccina tion, nutrition, growth, illnesses and accidents. The ACE impact on ISCM was analysed by multiple linear regression, and the d-Cohen test estimated its effect size.Spearman's correlation was used to analyse the cumulative ACE effect, measured by a score reflecting events such as family dysfunction, maternal mental health, poverty and exposure to violence.Results: Most infants were born prematurely (71.7%), had low birthweight (64.7%) and were exposed to three ACEs on average. The ISCM was lower in children exposed to maternal depression (P < 0.001, d-Cohen = 0.08), substance abuse by family members (P = 0.02, d-Cohen = 0.6) and marital conflicts (P = 0.03,d-Cohen = 0.7). The Spearman's correlation showed that the greater the exposure toACEs, the lower the ISCM (r = 0.40, P < 0.0001).Conclusion: Exposure to ACE, especially in the family environment, had negative effect on maternal care and child health. The impact could be detected in the first year of life and had cumulative effect. Our findings indicate the need for a broader approach to child health to minimize ACE's impacts.
Abstract
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Depressão, Física Médica, Disparidades Socioeconômicas em Saúde, Relações Mãe-Filho
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Depression, Family functioning, Infant, Maternal coping, Physical health, Social disadvantage
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https://onlinelibrary.wiley.com/doi/full/10.1111/cch.12951