Introduction

To examine associations between patient characteristics and adverse childhood experiences (ACEs) in a population-based sample of pediatric primary care patients, using electronic health records and clinical, administrative data.

Method

An observational study was conducted in an integrated health care delivery system. Children ages 1–5 years (N = 13,370) were screened for ACEs at routine well-child visits between September 1, 2018 and May 31, 2019 in three pediatrics clinics. Multivariate models examined associations between patient characteristics (age, gender, race/ethnicity, insurance type, neighborhood income and education level, physical, mental health and developmental diagnoses, weight status) and any ACEs, and ≥ 3 ACEs exposure.

Results

Prevalence and severity of ACE exposure varied by race/ethnicity. Older age, Medicaid insurance, epilepsy/seizure disorder, sleeping disorders, adjustment disorders, and feeding disorders were associated with higher odds of ACEs exposure, higher-income with lower odds.

Discussion

Understanding relationships between ACEs and patient features can provide information to clinicians for early detection and appropriate interventions.

中文翻译：

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与儿科初级保健中幼儿的不良童年经历相关的身体、心理健康和发育状况以及社会人口学特征

介绍

使用电子健康记录和临床管理数据，在基于人群的儿科初级保健患者样本中检查患者特征与不良童年经历 (ACE) 之间的关联。

方法

在综合医疗保健提供系统中进行了一项观察性研究。 2018 年 9 月 1 日至 2019 年 5 月 31 日期间，在三个儿科诊所的常规健康儿童访问中，对1-5 岁儿童 ( N = 13,370) 进行了 ACE 筛查。多变量模型检查了患者特征（年龄、性别、种族/民族、保险类型、邻里收入和教育水平、身体、心理健康和发育诊断、体重状态）与任何 ACE 和 ≥ 3 ACE 暴露之间的关联。

结果

ACE 暴露的患病率和严重程度因种族/民族而异。年龄较大、医疗补助保险、癫痫/癫痫症、睡眠障碍、适应障碍和喂养障碍与 ACE 暴露的几率较高、收入较高但几率较低有关。

讨论

了解 ACE 与患者特征之间的关系可以为临床医生提供信息以进行早期检测和适当的干预。