Childhood abuse could impact health of future generations

Researchers linked childhood abuse to poor health in the victim’s later life, and poor health in their children.

There are still many unanswered questions about how or why this happens, but researchers think substance abuse, especially during pregnancy, may play a role. For example, some evidence shows that maternal substance abuse (excessive drug use by a pregnant person) can cause the child to be born too early (premature) or too small. Premature birth, and a low birth weight, even if born at full term, both suggest the baby is less healthy.

But, researchers do not actually know how different types of abuse affect children in later life. So, they wanted to use computer models to investigate this in existing data. Their goal was to ask the model to divide the data into similar groups of people to see if there were similarities in their abuse.

These researchers used data previously gathered by the Evidence for Better Lives Study. That study assessed almost 1200 mother-baby pairs in 8 low- and middle-income countries (LMICs), including Ghana, South Africa, and Pakistan. They had the mothers answer questions about how they might have been abused when young, any substances they may currently use, and their baby's health.

These researchers then used a model called “Latent Class Analysis” to categorise the mother-baby pairs based on their answers.

The model found 4 groups: 1) highly abused, 2) emotionally and physically abused, 3) emotionally abused, and 4) low abuse. 

The researchers said 7% of the mothers were highly abused, 13% were emotionally and physically abused, 40% were emotionally abused, and 40% experienced little to no abuse.

Many mothers in the highly abused group saw and experienced physical, emotional, and sexual abuse within their families as children. Many in the emotionally and physically abused group also saw and experienced verbal and physical abuse within their families as children. 

In the emotionally abused group, many saw a family member verbally abuse another.

The 3 groups that experienced abuse were more likely to use illegal drugs. Interestingly, only the emotionally and physically abused group showed signs that their newborns might have low birth weight.

This may be the first study to focus on LMICs for this topic. Previous studies focused on high-income countries and found lower abuse rates (14%) than this study (39%). 

While those previous studies also suggested that childhood abuse causes alcohol use and smoking later in life, this study did not find this in LMICs. These researchers believe there may be cultural and religious factors at play in these countries that reduce alcohol use and smoking.

These researchers say that their findings may not be valid for these countries as a whole because the Evidence for Better Lives Study did not randomly choose mother-baby pairs. For logistical reasons, they chose mothers that matched specific requirements, like being able to regularly visit the same hospital.

They also said that the answers to questions may not have been completely honest. No one verified them, and mothers may not have wanted to share traumatic experiences.

The researchers suggested that more studies should be done on LMICs, and that future work focus on how severe, long, and regular abuse was rather than the types of abuse.

These researchers were from South Africa, Ghana, Pakistan, Philippines, Jamaica, UK, Australia, Sri Lanka, Romania, Vietnam, and Switzerland. Their work is especially relevant to Africa as it has many LMICs.

Abstract

Aims This paper explores the number and characterization of latent classes of adverse childhood experiences across the Evidence for Better Lives Study cohort and investigates how the various typologies link to prenatal substance use (i.e., smoking, alcohol, and illicit drugs) and poor infant outcomes (i.e., infant prematurity and low birth weight). Participants and setting A total of 1,189 mother-infant dyads residing in eight diverse low- and middle-income countries (LMICs) were recruited. Methods Latent class analysis using the Bolck, Croon, and Hagenaars (BCH) 3-step method with auxiliary multilevel logistic regressions with distal outcomes were performed. Results The LCA identified three high-risk classes and one low-risk class, namely: (1) highly maltreated (7%, n = 89), (2) emotionally and physically abused with intra-familial violence exposure (13%, n = 152), (3), emotionally abused (40%, n = 474), and (4) low household dysfunction and abuse (40%, n = 474). Overall, across all latent classes, there were low probabilities of prenatal substance use and poor infant outcomes. However, pairwise comparisons between classes indicate that class 1 and 3 had higher probabilities of prenatal illicit drug use compared to class 4. Additionally, class 2 had higher probability of low birth weight compared to the three remaining classes. Conclusion The results further our understanding of the dynamic and multifaceted nature of ACEs. More research grounded on LMICs is warranted with more attention to various parameters of risk exposure (i.e., severity, duration, chronicity).

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