Adverse Childhood Experiences and Lower Urinary Tract Symptoms and Impact Among Women

Purpose: This study utilizes CARDIA (Coronary Artery Risk Development in Young Adults) cohort study data to examine whether (1) family-based adverse childhood experiences, recalled by women aged 32 to 47, are associated with lower urinary tract symptoms and their impact, a composite variable with 4 levels (bladder health and mild, moderate, or severe lower urinary tract symptoms/impact), and (2) extensiveness of women's social networks in adulthood attenuates an association between adverse childhood experiences and lower urinary tract symptoms/impact. Materials and Methods: In 2000-2001, frequency of adverse childhood experiences exposure was retrospectively assessed. In 2000-2001, 2005-2006, and 2010-2011, extensiveness of social networks was assessed; scores were averaged. In 2012-2013, lower urinary tract symptoms/impact data were collected. Logistic regression analyses examined whether adverse childhood experiences, extensiveness of social networks, and their interaction were associated with lower urinary tract symptoms/impact, adjusting for age, race, education, and parity (n=1,302). Results: Recall of more frequent family-based adverse childhood experiences was associated with report of more lower urinary tract symptoms/impact over 10 years later (OR=1.26, 95% CI=1.07, 1.48). Social networks during adulthood appeared to attenuate the association between adverse childhood experiences and lower urinary tract symptoms/impact (OR=0.64, 95% CI=0.41, 1.02). Among women with less extensive social networks, estimated probability of experiencing moderate or severe lower urinary tract symptoms/impact vs bladder health or mild lower urinary tract symptoms/impact was 0.29 and 0.21 for those reporting an adverse childhood experiences frequency corresponding to more than a little vs rarely or none of the time, respectively. Among women with more extensive social networks, estimated probabilities were 0.20 and 0.21, respectively. Conclusions: Family-based adverse childhood experiences are related to lower urinary tract symptoms/impact vs bladder health in adulthood. Additional research is needed to corroborate the potentially attenuating effect of social networks.

Automated summary

This study examines the association between family-based adverse childhood experiences and lower urinary tract symptoms/impact in women aged 32-47. It also investigates whether the extent of women's social networks attenuates this association. The results show that more frequent family-based adverse childhood experiences are associated with a higher likelihood of lower urinary tract symptoms/impact. However, having a larger social network in adulthood appears to mitigate this association.