Citation

Minnis H. Lancet Public Health 2023; 8(3): e170-e171.

Copyright

(Copyright © 2023, Elsevier Publishing)

DOI

10.1016/S2468-2667(23)00035-X

PMID

36841557

Abstract

In their retrospective cohort study in The Lancet Public Health, Nora Moog and colleagues assessed the associations between maternal history of childhood maltreatment and health outcomes in offspring. The study included 4337 mother-child dyads from sociodemographically and ethnically diverse populations across the USA. In addition to the intergenerational study design, a major strength of this study was the focus on physical, mental, and neurodevelopmental conditions and on their combined burden--ie, multimorbidity. Maternal maltreatment was self-reported by adult mothers recalling their experiences of childhood abuse or neglect. As there is a high degree of overlap among maltreatment types, the authors derived latent classes of maltreatment for analysis: low abuse or neglect, emotional abuse or neglect, moderate physical or sexual abuse, and severe abuse or neglect. Six health outcomes were investigated in offspring: asthma, attention-deficit hyperactivity disorder (ADHD), autism spectrum disorder, internalising problems, obesity, and allergy. Mothers who reported childhood maltreatment were nearly four times as likely to have children at moderate risk of all five disorders, while mothers who experienced severe abuse or neglect had children at highest risk for all of the disorders except allergy.

The authors acknowledge that key questions remain about the transmission of risk between childhood maltreatment and health outcomes of offspring. One traditional explanation is that the maternal exposure to childhood maltreatment could affect the prenatal and postnatal environment of the child, leading to poor health outcomes. Another explanation that has been considered is that epigenetic changes resulting from maternal child maltreatment could influence child development. A third mechanism, alluded to in the limitations section of Moog and colleagues' study, is that intergenerational transmission could occur through familial factors, especially neurodevelopmental conditions. These associations between heritable neurodevelopmental conditions and poor health outcomes in offspring are an important alternative explanation for the findings. For example, studies have shown that ADHD and asthma are related, even in the absence of maltreatment. ADHD and obesity are also associated, especially in female offspring, also in the absence of maltreatment...

Language: en