Childhood maltreatment linked with higher risk of asthma and atopic disease

Children who experience a form of abuse or neglect may be more likely to suffer with diseases such as asthma, eczema or conjunctivitis compared to those who have not experienced abuse or neglect according to a new analysis.

New analysis published in eClinicalMedicine - a Lancet-owned journal that tracks innovations in healthcare - using more than 800,000 UK patient healthcare records suggests that patients who have experienced childhood maltreatment are significantly more likely to develop atopic diseases.

The study was led by a team from the University of Birmingham in conjunction with the ongoing Lancet Commission on Gender-Based Violence and the Maltreatment of Young People to examine whether victims of child abuse and neglect had more incidences of allergies and chronic lung diseases among UK populations in line with emerging evidence from other parts of the world.

Among all patients with suspected exposure to childhood maltreatment, there was 42% increased chance of asthma developing in survivors of maltreatment compared to the general public, and a total increased risk of atopic disease of 14%. For those with officially confirmed cases of maltreatment, there was a 31% higher risk of any atopic disease.

Dr Nicola Adderley, Associate Professor in Public Health at the University of Birmingham said:

“We decided to conduct the first large-scale study to explore this relationship between childhood maltreatment and atopic diseases using data from general practices in the UK. We found evidence to suggest that those who experience childhood maltreatment have the greatest risk of developing all atopic diseases, with the evidence strongest for asthma. Our findings add to previous research confirming the substantial ill-health burden associated with childhood maltreatment.”

Dr Sonica Minhas, Research Fellow in Public Health at the University of Birmingham said:

“There is a large burden of childhood maltreatment within society and our findings contribute to a large amount of existing research which documents the devastating mental and physical health downstream consequences. We need to improve our public health approach to both prevent childhood maltreatment in the first place and to prevent further sequelae once children have been exposed to abuse.”

Dr Katrina Nash, a medical doctor at the Royal Berkshire Hospital NHS Trust and co-investigator of the study said:

“There is an urgent need to fully consider the physical health consequences of trauma and manage this appropriately within the community and in hospitals. Our current system mostly manages these separately and there is often little consideration for mental health origins of disease whilst managing physical health.”

The authors note among the limitations of the paper that smoking status and ethnicity were not able to be included in regression analysis to determine which variables are relevant, due to a lack of data included in healthcare records.

Dr Nick Metheny, Assistant Professor of Nursing and Public Health Sciences at the University of Miami and Co-Director of the Secretariat for the Lancet Commission on Gender-Based Violence and the Maltreatment of Young People said:

“A major goal of this Commission is to better understand how violence across the life course impacts people’s health outcomes and, perhaps more importantly, adequately integrate these impacts into our understanding of the impact violence has on our society. These results will add to a growing realization that preventing violence and maltreatment is sound health and economic policy”