Inflammatory burden in adolescents with prolonged parent-child separation

Abstract

BackgroundProlonged parent–child separation is associated with a broad array of poor developmental outcomes. A potential pathway may be through changes in inflammatory processes. However, relatively little is known about the relationship between parent–child separation pattern (timing and duration) and inflammatory burden. The aim of this study was to investigate whether parent–child separation since birth is associated with inflammatory burden in adolescents. MethodsA total of 574 adolescents (mean age 12.07 years, SD: 0.62) were enrolled from rural areas of Chizhou, Anhui Province, China. Parent-child separation was reported mainly by primary caregivers, and other adverse childhood adversities (ACEs) were derived from adolescents semi-structured interview or questionnaire. Blood samples were collected from venepuncture for C-reactive protein (CRP) as well as soluble urokinase plasminogen activator receptor (suPAR). ResultsNearly 40% (232/574) participants experienced parent–child separation, among which more than 1 of 4 persistently separated from both parents since birth. Both CRP and suPAR levels were significantly higher among adolescents persistently separated from both parents, compared with those who did not separate from both parents (CRP: 1.75 vs. 1.36 mg/L, P < 0.001; suPAR: 2.85 ng/mL vs. 2.55 ng/mL, P < 0.001). After adjusted for demographic covariates, body mass index, ACEs as well as parental characteristics, persistent parent–child separation was associated with elevated suPAR (B = 0.30; 95% CI, 0.12–0.48) and CRP (B = 1.34; 95% CI, 1.02–1.75). No similar associations were observed between inflammatory burden with current or early childhood parent–child separation groups. Adolescents who exposed to persistent parent–child separation were more likely to have elevated suPAR levels even if they did not have elevated CRP levels (aOR, 4.26, 95% CI, 1.23–14.80; P = 0.022). ConclusionElevated inflammatory burden observed in persistent parent–child separation adolescents highlights the need to support children and adolescents undergoing separation from both parents in order to minimize the long-term impact on disease vulnerability.