Adverse Childhood Events and Health Biomarkers: A Systematic Review

Front Public Health. 2021 Aug 19;9:649825. doi: 10.3389/fpubh.2021.649825. eCollection 2021.


Background: This systematic review aimed to summarize evidence reporting epigenetic and/or neuro-immuno-endocrine embedding of adverse childhood events (ACEs) in children, with a particular focus on the short-term biological effect of those experiences. Methods: A search was conducted in PsycINFO®, PubMed®, Isi Web of Knowledge and Scopus, until July 2019, to identify papers reporting the short-term biological effects of exposure to ACEs. Results: The search identified 58 studies, that were included in the review. Regarding exposure, the type of ACE more frequently reported was sexual abuse (n = 26), followed by life stressors (n = 20) and physical abuse (n = 19). The majority (n = 17) of studies showed a positive association between ACEs and biomarkers of the immune system. Regarding DNA methylation 18 studies showed more methylation in participants exposed to ACEs. Two studies presented the effect of ACEs on telomere length and showed that exposure was associated with shorter telomere length. Conclusion: Overall the associations observed across studies followed the hypothesis that ACEs are associated with biological risk already at early ages. This is supporting evidence that ACEs appear to get "under the skin" and induce physiological changes and these alterations might be strongly associated with later development of disease.

Keywords: ACES; adverse childhood events; biology of social adversity; biomarkers; review—systematic.

Publication types

  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Biomarkers
  • Child
  • DNA Methylation*
  • Humans
  • Physical Abuse*


  • Biomarkers