Epigenetic Responses to Abusive versus Accidental Injuries in Children: A Cross-sectional Epigenome Wide Association Meta-analysis

Abstract Child maltreatment is a leading cause of pediatric morbidity and mortality, potentially propagated by DNA methylation (DNAm) changes. We conducted an EWAS meta-analysis (n=175, 554,979 Illumina EPICv1/EPICv2 sites) in buccal swabs from three hospital-based studies of children with traumatic injuries, stratified by study group to include 1) any traumatic injury, 2) fractures, and 3) traumatic brain injuries. Empirical bayes-moderated linear models tested differential DNAm with M-values, followed by near-promoter gene set enrichment analysis. Abuse was associated with methylation at 11 sites (q