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J Dev Orig Health Dis. 2020 Jan 15:1-8. doi: 10.1017/S2040174419000886. [Epub ahead of print]

Latent factors of adverse childhood experiences and adult-onset asthma.

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Department of Obstetrics & Gynecology, University of Alberta, Edmonton, Alberta, Canada.
Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
Departments of Pediatrics and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.


Asthma is a chronic respiratory disease with complex etiology. Adverse childhood experiences (ACEs) have been linked to asthma in adulthood. Underlying potential mechanisms for the ACE-asthma relationship include stress-induced inflammatory pathways and immune dysregulation. We conducted a cross-sectional secondary data analysis of the 2013 Alberta ACE Survey to explore the relationship between latent ACE factors and self-reported adult asthma. We evaluated the underlying correlation structure among eight different ACEs using exploratory factor analysis. We conducted a logistic regression model to evaluate whether ACE factors retained from the factor analysis predicted self-reported asthma in adulthood. Results were reported as odds ratios (ORs) with 95% confidence intervals (CIs). We analyzed ACE survey results from 1207 participants. Factor analysis yielded four ACE latent factors: factor 1/relational violence, factor 2/negative home environment, factor 3/illness at home, and factor 4/sexual abuse. Results of the logistic regression showed that experiencing sexual abuse (OR: 3.23; 95% CI: 1.89, 5.23), relational violence (OR: 1.99; 95% CI: 1.17, 3.38), and being exposed to a negative home environment (OR: 1.86; 95% CI: 1.03, 3.35) were predictive of a diagnosis of asthma in adulthood, whereas living in a household with someone experiencing illness did not show an effect (OR: 1.38; 95% CI: 0.75, 2.56). Factor analysis provides an effectual approach to understand the long-term impact of ACEs on respiratory health. Our findings have important implications to understand the developmental origins of asthma in adulthood and inform interventions aimed at reducing the lasting negative impact of childhood adversities on future respiratory health.


Adverse childhood experiences; adult asthma; early-life exposures; exploratory factor analysis; latent factors


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