Association between adverse childhood experiences and asthma: a meta-analysis

OBJECTIVE: The study explored whether there is an association between adverse childhood experiences (ACEs) and asthma through meta-analysis. METHODS: PubMed, Embase, Cochrane Library, and Web of Science were systematically searched up to May 20, 2024. Observational studies reporting associations between adverse childhood experiences (ACEs) and asthma were included. Two reviewers independently screened studies, extracted data, and assessed study quality. Odds ratios (ORs) with 95% confidence intervals (CIs) were pooled using a random-effects model in Stata 15.0. Heterogeneity was evaluated using the I² statistic, publication bias was assessed with Egger’s test and funnel plots, and study quality was evaluated using established assessment tools. RESULT: Sixteen articles (n = 1,291,133) were included. Experiencing ≥ 1 ACE was associated with an increased risk of asthma [adjusted OR = 1.18, 95% CI (1.12–1.24); I²=86.7%, P < 0.001]. Exposure to 2–3 ACEs was associated with asthma [adjusted OR = 1.55, 95% CI (1.45–1.66); I²=38.2%, P = 0.138], and ≥ 4 ACEs showed the highest risk [adjusted OR = 1.98, 95% CI (1.72–2.27); I²=63.3%, P = 0.012]. Sensitivity analyses using the leave-one-out method indicated that the pooled estimates were robust and stable. CONCLUSION: The current study found a positive relationship between ACEs and asthma, and as the number of ACEs experienced increases, the likelihood of asthma also rises. These findings underscore the importance of early identification and psychosocial support for children exposed to adversity, which may help reduce the long-term risk of asthma and improve overall respiratory health.