Prevalence and factors associated with adverse early childhood experiences: a population-based study in Ceará, Brazil

• Published in: Revista brasileira de epidemiologia 2022-01, Vol.25, p.e220035-e220035
• Main Authors: Martins, Maria Iara Socorro, Rocha, Hermano Alexandre Lima, Leite, Álvaro Jorge Madeiro, Rocha, Sabrina Gabriele Maia Oliveira, Araújo, David Augusto Batista Sá, Machado, Márcia Maria Tavares, Campos, Jocileide Sales, Sampaio, Edgar Gomes Marques, Silva, Anamaria Cavalcante e, Correia, Luciano Lima
• Format: Article
• Language: English
• Subjects: Adverse childhood experiences; Brazil; Prevalence; PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH; Socioeconomic factors
• ISSN: 1415-790X; 1980-5497; 1980-5497
• DOI: 10.1590/1980-549720220035

ABSTRACT Objective: To estimate the prevalence of adverse childhood experiences and identify associated factors. Methods: A population-based cross-sectional study comprised data from a sample of 3,200 households with 3,566 children under 6 years of age, representative of the state of Ceará, Brazil. A multistage sampling approach was used, with stratification among the state capital, Fortaleza, and the 28 countryside municipalities, in which 160 census tracts were randomly selected, each one with a cluster of 20 households. The outcome variable was structured based on adverse childhood experiences as suggested by the Center for Disease Control and Prevention, according to the number of situations to which the child was exposed: 0–2, 3–5, and 6–9. Ordinal logistic regression multivariate model was applied to assess associations. Results: Among the 3,566 children studied, 89.7% (95%CI 88.7–90.7) were exposed to at least one adverse experience, of which the most prevalent were neglect, and emotional/physical abuse. The main factors associated were maternal advanced age and smoking, paternal absence, low education level of the head of the family, food insecurity and lack of a social support network. Conclusion: The study found a high occurrence of adverse early childhood experiences, particularly among preschool children born to mothers of older age, solo, who smoke and in a situation of social and economic vulnerability, including food insecurity, who should be target of control and prevention measures. RESUMO Objetivo: Estimar a prevalência de experiências adversas na infância e identificar fatores associados. Métodos: O estudo transversal de base populacional compreendeu os dados de uma amostra de 3.200 domicílios com 3.566 crianças menores de seis anos, representativa do estado do Ceará, Brasil. Foi utilizado um processo de amostragem multiestágio, com estratificação entre a capital do estado, Fortaleza, e os 28 municípios do interior, nos quais foram sorteados 160 setores censitários, cada qual com um conglomerado de 20 domicílios. A variável desfecho foi estruturada com base nas situações de experiências adversas na infância sugeridas pelo grupo Centers for Disease Control and Prevention, de acordo com o número de situações a que a criança foi exposta: 0–2, 3–5 e 6–9. O modelo multivariado de regressão logística ordinal foi utilizado para avaliar as associações. Resultados: Das 3.566 crianças estudadas, 89,7% (intervalo de confiança — IC95% 88,7–90,7) for