Long-term health consequences of childhood adverse events: A narrative review

Abstract

“Adverse childhood events” or childhood adversity is a term often used to describe trauma and sources of stress during childhood or adolescence. Childhood adversity may negatively affect multiple aspects of an adult's life, such as cardiovascular disease, cancer, mental disorders, including substance abuse, as well as infertility and gynecological conditions, such as endometriosis, fibroids and polycystic ovarian syndrome. A negative psychosocial environment during childhood may increase the incidence of cardiovascular risk factors, such as dyslipidemia, diabetes, arterial hypertension and abdominal obesity, even from adolescence. This accelerates atherosclerotic processes and predisposes to higher cardiovascular morbidity and mortality even from early adulthood. The higher the number and severity of childhood adverse events, the higher is the risk of cardiovascular disease. Adverse childhood events may also be implicated in tumorigenesis, since they have been associated with an increased risk of cancer, either directly or indirectly, due to increased prevalence of causal factors and behaviors, such as smoking and obesity. This is also the case for infertility and mental disorders. Although the exact pathogenetic pathways have not been clarified, chronic stress during childhood and adolescence, which provides a state of low-grade systematic inflammation and dysregulation of the hypothalamus-pituitary-adrenal axis, may be a common basis for these comorbidities. In any case, there is an exigent need for strategies to promptly identify and treat these patients at risk of developing these long-term health problems associated with childhood adversity.