Introduction
More than 200 million children fail to reach their full developmental potential in
low- and middle-income countries. Adverse childhood experiences, maternal mental health,
and intimate partner violence are negatively associated with child development outcomes.
The relationship of these risk factors with child communication, gross motor, fine
motor, problem-solving, and personal–social development scores in Brazil are assessed.
Methods
A population-based, cross-sectional study of preschool children living in the state
of Ceará, Brazil, in 2017 was conducted. Child development was assessed with the Ages
and Stages Questionnaire. Adverse childhood experiences for children were self-reported
by the participants’ mothers using the Centers for Disease Control and Prevention
Adverse Childhood Experiences Study‒adapted metric. Maternal mental health and intimate
partner violence were evaluated using validated questionnaires. Sample-adjusted multivariable
generalized linear models with interaction terms were used to determine the association
of intimate partner violence, maternal mental health, and adverse childhood experiences
with developmental outcomes and identify possible moderators. Data were analyzed between
2019 and 2020.
Results
Children exposed to ≥3 adverse childhood experiences had −0.12 (95% CI= −0.24, 0)
lower communication, −0.25 (95% CI= −0.46, −0.03) lower gross motor, −0.27 (95% CI=
−0.47, −0.07) lower fine motor, and −0.17 (95% CI= −0.3, −0.03) lower personal–social
domain scores than children with no adverse childhood experiences. Furthermore, the
greater number of adverse childhood experiences was linearly associated with lower
developmental scores. Maternal mental health and intimate partner violence were also
associated with lower development scores.
Conclusions
Adverse childhood experiences were independently associated with developmental outcomes
in Brazilian children. Community-based interventions to reduce the impact of adverse
childhood experiences, intimate partner violence, and maternal mental health may benefits
child development outcomes.
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Article Info
Publication History
Published online: November 04, 2020
Identification
Copyright
© 2020 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
