Childhood maltreatment predicts adult inflammation in a life-course study

Abstract

Stress in early life has been associated with insufficient glucocorticoid signaling in adulthood, possibly affecting inflammation processes. Childhood maltreatment has been linked to increased risk of adult disease with potential inflammatory origin. However, the impact of early life stress on adult inflammation is not known in humans. We tested the life-course association between childhood maltreatment and adult inflammation in a birth cohort followed to age 32 years as part of the Dunedin Multidisciplinary Health and Development Study. Regression models were used to estimate the effect of maltreatment on inflammation, adjusting for co-occurring risk factors and potential mediating variables. Maltreated children showed a significant and graded increase in the risk for clinically relevant C-reactive protein levels 20 years later, in adulthood [risk ratio (RR)=1.80, 95% confidence interval (CI)=1.26-2.58]. The effect of childhood maltreatment on adult inflammation was independent of the influence of co-occurring early life risks (RR=1.58, 95% CI=1.08-2.31), stress in adulthood (RR=1.64, 95% CI=1.12-2.39), and adult health and health behavior (RR=1.76, 95% CI=1.23-2.51). More than 10% of cases of low-grade inflammation in the population, as indexed by high C-reactive protein, may be attributable to childhood maltreatment. The association between maltreatment and adult inflammation also generalizes to fibrinogen and white blood cell count. Childhood maltreatment is a previously undescribed, independent, and preventable risk factor for inflammation in adulthood. Inflammation may be an important developmental mediator linking adverse experiences in early life to poor adult health.

Fig. 1.

The association of childhood maltreatment with biomarkers of inflammation. (A) Mean (and SE) of logged hsCRP according to maltreatment experiences. In an ordinary least-squares regression model adjusted for sex and antiinflammatory drug use, definite maltreatment (b = 0.35, SE = 0.13, t = 2.58; P = 0.01), but not probable maltreatment (b = 0.09, SE = 0.09, t = 1.07; P = 0.29), predicted an increase in logged hsCRP levels. (B) Mean (and SE) of fibrinogen according to maltreatment experiences. Definite maltreatment (b = 0.15, SE = 0.07, t = 2.20; P = 0.03), but not probable maltreatment (b = 0.06, SE = 0.04, t = 1.39; P = 0.17), predicted an increase in fibrinogen levels. (C) Mean (and SE) of WBC count according to maltreatment experiences. Both probable maltreatment (b = 0.55, SE = 0.14, t = 3.95; P < 0.001) and definite maltreatment (b = 0.67, SE = 0.21, t = 3.18; P = 0.002) predicted an increase in WBC count. (D) Mean (and SE) of a factor score for inflammation according to maltreatment experiences. The inflammation factor has a standardized mean of 0 and SD of 1. Both probable maltreatment (b = 0.19, SE = 0.08, t = 2.44; P = 0.02) and definite maltreatment (b = 0.39, SE = 0.12, t = 3.36; P = 0.001) predicted an increase in the factor score for inflammation.