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Trayectorias de la adversidad infantil y la mortalidad en la edad adulta temprana: un estudio de cohorte basado en la
Naja H Rod1, Jessica Bengtsson1, Esben Budtz-Jørgensen2
1Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
Lancet (London, England)
|August 18, 2020
Resumen
La adversidad de la infancia, incluida la privación y la pérdida de la familia, aumenta el riesgo de mortalidad en la edad adulta temprana. Un pequeño grupo con múltiples adversidades se enfrentó a un riesgo significativamente mayor, lo que pone de relieve una preocupación crítica de salud pública.
Área de la Ciencia:
- Salud pública
- Epidemiología
- Psicología del desarrollo
Sus antecedentes:
- La infancia es un período crítico de desarrollo en el que las experiencias adversas pueden tener impactos duraderos en la salud.
- Las experiencias adversas de la infancia (ACE) pueden interrumpir el desarrollo normal y aumentar la vulnerabilidad a problemas de salud más adelante en la vida.
Objetivo del estudio:
- Para describir las trayectorias de experiencias adversas de la infancia.
- Investigar la asociación entre estas trayectorias y la mortalidad en la edad adulta temprana.
Principales métodos:
- Estudio de cohorte basado en la población utilizando registros nacionales daneses (1980-2015).
- Incluido más de 1 millón de niños, analizando datos desde el nacimiento hasta los 34 años.
- Se utilizó el agrupamiento de trayectorias múltiples basado en grupos y el análisis de supervivencia (modelos Cox y Aalen).
Principales resultados:
- Se identificaron cinco trayectorias distintas de adversidad en la infancia.
- Los niños que experimentaron privación material o pérdida o amenaza de pérdida tenían un riesgo de mortalidad moderadamente mayor.
- Un pequeño grupo (3%) con múltiples adversidades en todas las dimensiones se enfrentó a un riesgo de mortalidad 4,54 veces mayor, con accidentes, suicidios y cáncer como causas principales.
Conclusiones:
- Casi la mitad de los niños daneses experimentaron alguna adversidad, relacionada con el aumento de la mortalidad adulta.
- Las adversidades múltiples en la infancia elevan significativamente el riesgo de mortalidad en la edad adulta temprana.
- Estos hallazgos subrayan la necesidad de intervenciones de salud pública dirigidas a niños que enfrentan múltiples adversidades.
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