Pediatric Adverse Childhood Experiences and Related Life Events Screener (PEARLS-BR): prevalence and health outcomes in a Brazilian context

Abstract

Introduction: This study explores the associations between Adverse Childhood Experiences (ACEs) and child health in Brazil using data from the PEARLS-BR study. It aims to assess the prevalence and impact of ACEs in a Brazilian cultural context and their relationship with health outcomes. Methods: A cross-sectional study was conducted at a Multidisciplinary Health Care Clinical Center and a General Hospital-Reference Center for Child and Adolescent Care, involving 202 caregivers of children and teens aged 0 to 18 years. The PEARLS-BR instrument was used to document the frequency and distribution of ACEs and related life events and their association with health outcomes. Results: Caregivers participants reported a median of 2 (IQR 1-5) adversities of their child, with 78.2% reporting at least one adversity. Higher PEARLS-BR scores were significantly associated with poorer physical health (OR: 1.18, 95% CI: 1.01–1.38) and mental health (OR: 1.50, 95% CI: 1.33–1.71), ADHD symptoms (OR: 1.21, 95% CI: 1.09–1.37), infections (OR: 1.13, 95% CI: 1.02–1.26), gastrointestinal disorders (OR: 1.26, 95% CI: 1.12–1.43), and headaches/migraines (OR: 1.22, 95% CI: 1.11–1.35). Related life events were linked to higher odds of obesity (OR: 1.37, 95% CI: 1.02–1.88) and atopic conditions (OR: 1.28, 95% CI: 1.01–1.63). Conclusions: The PEARLS-BR score identifies children at risk for various adverse health outcomes. The study highlights the need for targeted interventions and comprehensive strategies to address the impact of childhood adversities on health, providing valuable insights for public health strategies and clinical practices in Brazil.