Association Between Parental Adverse Childhood Experiences and Offspring’s Risk of Suboptimal Health: A Systematic Review and Meta-Analysis

Abstract

Previous reviews and meta-analysis have not adequately explored the impact of specific parental adverse childhood experiences (ACEs) subtypes on offspring’s health. This updated systematic review and meta-analysis aimed to investigate the association between parental ACE subtypes and various offspring health outcomes. A comprehensive search was conducted in electronic databases including PubMed, Web of Science, the Cochrane Library, WANFANG, and China National Knowledge Infrastructure for studies published in English and Chinese from January 1, 1998, until July 18, 2023. Two independent reviewers screened studies, extracted data, and assessed study quality using the Newcastle-Ottawa Scale. A random-effects model was applied to generate pooled odds ratios (ORs) and 95% confidence interval (95% CI). A total of 47 eligible studies were included in the final analysis. Overall, parental ACEs were significantly associated with several offspring’s health outcomes, including preterm birth (PTB), low birth weight (LBW), total developmental delay, social-emotional problems, and behavioral problems (total, externalizing and internalizing behaviors), with ORs ranging from 1.06 to 3.02. Specific subtypes of parental ACEs, such as household dysfunction, sexual abuse, and physical abuse (but not emotional abuse) were significantly associated with PTB. Household dysfunction was notably linked to delayed cognition ability in offspring. Parental sexual abuse, physical abuse, emotional abuse, and emotional neglect were significantly correlated with social-emotion problems, with the expception of household dysfunction. Regarding total behavioral problems, parental household dysfunction, physical abuse, emotional abuse, physical neglect, and peer bullying were all significantly associated with children’s behavioral issues, except for emotional neglect. There is a positive correlation between parental household dysfunction, sexual abuse, physical abuse, emotional abuse, emotional neglect, physical neglect, peer bullying, and neighborhood-related adversity and their children’s externalizing behavior problems. These findings underscore the significant impacts of parental ACEs on multiple adverse health outcomes in children, with specific parental ACEs subtypes exerting unique effects. This highlight the significance of comprehending the intergenerational effects of different ACE subtypes, and emphasizes the urgency of interventions to address these issues.