Adverse childhood experiences and premature all-cause mortality

TLDR

Stressful events during critical childhood periods may predispose individuals to premature all‑cause mortality. Using the 1958 British birth cohort, researchers examined the association between prospectively recorded adverse childhood experiences and mortality before age 50 in men and women, employing Cox regression adjusted for early‑life and 23‑year‑old characteristics. Men with two or more adverse childhood experiences had a 57 % higher risk of death before age 50, while women showed a graded increase—66 % higher risk with one ACE and 80 % with two or more—suggesting that early biological embedding, rather than adult lifestyle, underlies the link to premature mortality.

Abstract

Events causing stress responses during sensitive periods of rapid neurological development in childhood may be early determinants of all-cause premature mortality. Using a British birth cohort study of individuals born in 1958, the relationship between adverse childhood experiences (ACE) and mortality≤50 year was examined for men (n=7,816) and women (n=7,405) separately. ACE were measured using prospectively collected reports from parents and the school: no adversities (70%); one adversity (22%), two or more adversities (8%). A Cox regression model was carried out controlling for early life variables and for characteristics at 23 years. In men the risk of death was 57% higher among those who had experienced 2+ ACE compared to those with none (HR 1.57, 95% CI 1.13, 2.18, p=0.007). In women, a graded relationship was observed between ACE and mortality, the risk increasing as ACE accumulated. Women with one ACE had a 66% increased risk of death (HR 1.66, 95% CI 1.19, 2.33, p=0.003) and those with ≥2 ACE had an 80% increased risk (HR 1.80, 95% CI 1.10, 2.95, p=0.020) versus those with no ACE. Given the small impact of adult life style factors on the association between ACE and premature mortality, biological embedding during sensitive periods in early development is a plausible explanatory mechanism.