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. 2024 Dec:189:108153.
doi: 10.1016/j.ypmed.2024.108153. Epub 2024 Oct 19.

Association between self-reported child maltreatment and risk of hospital-treated infectious diseases in middle-aged and older adults: A UK Biobank cohort study

Yifang Huang  1 , Ruilang Lin  2 , Wenhao Wang  3 , Lulu Pan  2 , Chen Huang  2 , Yongfu Yu  2 , Guoyou Qin  4 , Zhijun Bao  5 , Xueying Zheng  6
Affiliations

Association between self-reported child maltreatment and risk of hospital-treated infectious diseases in middle-aged and older adults: A UK Biobank cohort study

Yifang Huang et al. Prev Med. 2024 Dec.

Abstract

Objective: This study aimed to explore the association between child maltreatment and hospital-treated infectious diseases in middle-aged and older adults.

Methods: 145,151 participants aged 38-72 years from the UK Biobank between 2006 and 2010 were enrolled and interviewed. Child maltreatment included five types: physical abuse, physical neglect, emotional abuse, emotional neglect, and sexual abuse. Patterns of maltreatment were identified using latent class analysis (LCA). Cox regression was employed to estimate the associations between child maltreatment (number of types, individual types, and patterns) and infectious diseases. Further, we evaluated potential mediators using mediation analysis.

Results: Over a median follow-up of 13.4 years, 22,688 participants (12.26 per 1000 person-years) were hospitalized for an infectious disease. Participants reporting any maltreatment had elevated infectious diseases risk (HR 1.18, 95 % CI: 1.15-1.21) than those without maltreatment. A dose-response relationship was observed between the number of maltreatment types and infectious disease (one, HR 1.09 [95 % CI 1.06-1.13]; two, HR 1.17 [95 % CI 1.12-1.23]; three to five, HR 1.48 [95 %CI 1.41-1.55]; Ptrend < 0.001). Each type of maltreatment was associated with increased infectious diseases risk. LCA identified four patterns (low maltreatment, child neglect, child abuse, and poly-maltreatment), with those who experienced poly-maltreatment exhibiting the highest infectious diseases risk (HR 1.51, 95 % CI: 1.43-1.59). The association between child maltreatment and infectious diseases was mediated by C-reactive protein, phenotypic age acceleration, loneliness, psychiatric disorders, and unhealthy lifestyles.

Conclusions: Child maltreatment may increase susceptibility to a broad spectrum of infectious diseases in adulthood, highlighting the need for early-life maltreatment prevention policies.

Keywords: Abuse; Child maltreatment; Infectious diseases; Neglect; Sexual abuse.

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Conflict of interest statement

Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.