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Childhood adversity and accelerated reproductive events: a systematic review and meta-analysis - 06/03/24

Doi : 10.1016/j.ajog.2023.10.005 
Wenqin Ding, MSc a, Yuxiang Xu, MD a, Anthony J. Kondracki, MD b, Ying Sun, MD a, c, d,
a Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China 
b Department of Community Medicine, Mercer University School of Medicine, Macon, GA 
c Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Ministry of Education of the People’s Republic of China, Hefei, China 
d Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China 

Corresponding author: Ying Sun, MD.

Abstract

Objective

Accelerated female reproductive events represent the early onset of reproductive events involving puberty, menarche, pregnancy loss, first sexual intercourse, first birth, parity, and menopause. This study aimed to explore the association between childhood adversity and accelerated female reproductive events.

Data Sources

PubMed, Web of Science, and Embase were systematically searched from September 22, 2022 to September 23, 2022.

Study Eligibility Criteria

Observational cohort, cross-sectional, and case–control studies in human populations were included if they reported the time of reproductive events for female individuals with experience of childhood adversity and were published in English.

Methods

Two reviewers independently screened studies, obtained data, and assessed study quality, and conflicts were resolved by a third reviewer. Dichotomous outcomes were evaluated using meta-analysis, and pooled odds ratios and 95% confidence intervals were generated using random-effects models. Moderation analysis and meta-regression were used to investigate heterogeneity.

Results

In total, 21 cohort studies, 9 cross-sectional studies, and 3 case–control studies were identified. Overall, female individuals with childhood adversity were nearly 2 times more likely to report accelerated reproductive events than those with no adversity exposure (odds ratio, 1.91; 95% confidence interval, 1.33–2.76; I2=99.6%; P<.001). Moderation analysis indicated that effect sizes for the types of childhood adversity ranged from an odds ratio of 1.61 (95% confidence interval, 1.23–2.09) for low socioeconomic status to 2.13 (95% confidence interval, 1.14–3.99) for dysfunctional family dynamics. Among the 7 groups based on different reproductive events, including early onset of puberty, early menarche, early sexual initiation, teenage childbirth, preterm birth, pregnancy loss, and early menopause, early sexual initiation had a nonsignificant correlation with childhood adversity (odds ratio, 2.70; 95% confidence interval, 0.88–8.30; I2=99.9%; P<.001). Considerable heterogeneity (I2>75%) between estimates was observed for over half of the outcomes. Age, study type, and method of data collection could explain 35.9% of the variance.

Conclusion

The literature tentatively corroborates that female individuals who reported adverse events in childhood are more likely to experience accelerated reproductive events. This association is especially strong for exposure to abuse and dysfunctional family dynamics. However, the heterogeneity among studies was high, requiring caution in interpreting the findings and highlighting the need for further evaluation of the types and timing of childhood events that influence accelerated female reproductive events.

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Key words : abuse, adverse childhood experiences, childhood adversity, life history theory, meta-analysis, reproductive events, reproductive timing, systematic review


Plan


 W.D. and Y.X. contributed equally to this work.
 The authors report no conflict of interest.
 This study was supported by the National Natural Science Foundation of China (No. 82173537, 81872638).
 Date of PROSPERO registration: November 25, 2022
 PROSPERO registration number: CRD42022359595


© 2023  Elsevier Inc. Tous droits réservés.
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Vol 230 - N° 3

P. 315 - mars 2024 Retour au numéro
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