Adverse childhood experiences and allergic diseases: A scoping review

Background: One in seven individuals experience at least four adverse childhood experiences (ACE). These experiences have been associated with poor health outcomes. Objectives: The objective was to map the association between ACEs and asthma, food allergy, allergic rhinitis, atopic dermatitis, urticaria, and mast cell activation syndrome. Methods: Original research that evaluated the association between ACEs and asthma, food allergy, allergic rhinitis, atopic dermatitis, urticaria, or mast cell activation syndrome was selected and abstracted. Review articles and non-peer-reviewed literature were excluded. Sources of evidence included several medical literature databases from inception to April 3, 2026. Each article was reviewed in duplicate at title and abstract, full text, and data extraction, with conflicts resolved by consensus or independent review. Quality assessment was conducted by using a modified assessment tool. Results: After duplicate removal (181 articles), 357 full-text articles were evaluated, with 267 studies excluded. The full text of 90 articles was assessed for eligibility, with 31 studies excluded (1 preprint, 11 wrong outcome, 1 wrong exposure, 17 wrong study design, 1 wrong population). The studies were subject to recall bias and limitations in terms of diagnostic accuracy of the outcome. Of 59 studies selected for inclusion in the review, 57 focused primarily on asthma/lung disease, 6 variably reported on poorly described allergy outcomes, and 2 reported on atopic dermatitis. No studies were identified that explored the association between ACEs and food allergy, urticaria, or mast cell activation syndrome. There is available evidence of an association of ACEs and asthma risk with a potential dose-response effect noted, indicating the possibility of a greater risk with greater ACE exposure. Conclusion: An association between ACEs and asthma is suggested. More research is needed to understand the impact of ACEs on other conditions evaluated by allergist/immunologists.