Early origins of inflammation: An examination of prenatal and childhood social adversity in a prospective cohort study
Section snippets
Sample
Participants were offspring of pregnant women enrolled between 1959 and 1966 in the Collaborative Perinatal Project (CPP) (Broman et al., 1975, Niswander and Gordon, 1972). At the time of enrollment, expectant mothers provided comprehensive data on health, behavior, and demographic characteristics; subsequent information on mothers and their offspring was collected at birth and periodically through the child's first 7 years. The New England Family Study (NEFS) was initiated to locate and
Social adversity
We created composite scores of social adversity prenatally and during early childhood (Evans et al., 2013, Sameroff, 1998). This approach accounts for the clustering of risk factors together, and allows for the examination of the inflammatory consequences of exposure to multiple forms of adversity at each time point. Consistent with prior research that has compared advantaged and disadvantaged groups of children into adulthood, we collapsed the prenatal and childhood adversity scores into
Analyses
Regression analyses were used to examine associations of prenatal and childhood adversity with CRP in adulthood. First, we conducted a series of linear regression models that evaluated associations between prenatal and childhood adversity and CRP, with scores for prenatal and childhood adversity included individually and together in the same model. If both prenatal and childhood adversity are associated with CRP independent of each other, coefficients for both prenatal and childhood adversity
Results
Characteristics of the sample are presented in Table 1. The sample had more females (57.75%) than males, and was predominantly white (80.66%). Ages at the adult follow-up ranged from 39 to 47 (mean ± SD, 42.07 ± 1.70). Approximately 37 percent of the sample was in the medium prenatal adversity category, and 8 percent of the sample was in the high prenatal adversity category. Considering childhood adversity, 44 percent of the sample was in the medium adversity category, and 9 percent was in the high
Discussion
We sought to investigate the independent associations of prenatal and childhood adversity with adulthood inflammation, consistent with a life course accumulation model. When prenatal and childhood adversity were considered separately, each was associated with higher levels of inflammation in adulthood after adjustment for individual characteristics (age, sex, race) and other potential confounders including pre-existing maternal health conditions. When we analyzed the effects of prenatal and
Role of the funding source
There has been no financial support for this work that could have influenced its outcome.
Conflict of interest statement
The authors have no conflicts of interest to report.
Acknowledgments
This research was supported by grants from the National Institutes of Health (MH087544, PI: Gilman; AG023397, PI: Buka), the Robert Wood Johnson Foundation (RWJF ID #67751), and the W. K. Kellogg Foundation (P3022586). We appreciate the contributions of Ms. Kathleen McGaffigan, our expert analyst and data manager.
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