Myocardial infarction in parents who lost a child: A nationwide prospective cohort study in Denmark
Child; Parents
2002
Li J; Hansen D; Mortensen PB; Olsen J
Circulation
2002
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1161/01.cir.0000031569.45667.58" target="_blank" rel="noreferrer">10.1161/01.cir.0000031569.45667.58</a>
Cancer incidence in parents who lost a child: a nationwide study in Denmark
Child; Female; Humans; Male; Longitudinal Studies; Risk Factors; Incidence; Stress; bereavement; Denmark/epidemiology; Parents/psychology; Causality; Neoplasms/epidemiology/mortality/psychology; Psychological/complications
BACKGROUND: It has been debated whether psychological stress causes cancer, but the scientific evidence remains contradictory. The objective of this study was to investigate whether the death of a child is related to cancer risk in bereaved parents. METHODS: The authors undertook a follow-up study based on national registers. All 21,062 parents who lost a child from 1980 to 1996 were recruited for the exposed cohort together with 293,745 randomly selected, unexposed parents. Cox proportional hazards regression models were used to evaluate the relative risk of cancer incidence up to 18 years after the bereavement. The main outcomes of interest were all incident cancers, breast carcinoma, smoking-related malignancies (International Classification of Diseases [ICD] 7 codes 140, 141, 143-149, 150, 157, 160-162, 180, and 181), alcohol-related malignancies (ICD7 codes 141, 143-146, 148-150, 155, and 161), virus/immune-related malignancies (ICD7 codes 155, 171, 191, 200-202, and 204), lymphatic/hematopoietic malignancies (ICD7 codes 200-205), and hormone related malignancies (ICD7 codes 170, 172, 175, and 177). RESULTS: The authors observed a slightly increased overall cancer risk in bereaved mothers (relative risk [RR], 1.18; 95% confidence interval [95%CI], 1.01-1.37; P = 0.028) at 7-18 years of follow-up. There was an increased risk for smoking-related malignancies (RR, 1.65; 95%CI, 1.05-2.59; P = 0.010) among bereaved mothers during the 7-18 years of follow-up. The authors observed no significantly increased relative risk of breast carcinoma, alcohol-related malignancies, virus/immune-related malignancies, or hormone-related malignancies. CONCLUSIONS: The current data suggest that the death of a child was associated with a slightly increased overall cancer risk in mothers and that the increase may be related to stress-induced adverse life styles.
2002
Li J; Johansen C; Hansen D; Olsen J
Cancer
2002
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Journal Article
<a href="http://doi.org/10.1002/cncr.10943" target="_blank" rel="noreferrer">10.1002/cncr.10943</a>
Hospitalization for mental illness among parents after the death of a child.
Child; Female; Humans; Male; Adult; Follow-Up Studies; Middle Aged; Death; Longitudinal Studies; Sex Factors; Life Change Events; Hospitals; Risk; Regression Analysis; Registries; Preschool; Non-U.S. Gov't; Research Support; bereavement; infant; Comparative Study; Parents/psychology; Substance-Related Disorders/epidemiology; Hospitalization/statistics & numerical data; Mental Disorders/epidemiology; Mood Disorders/epidemiology; Psychiatric; Schizophrenia/epidemiology
BACKGROUND: The loss of a child is considered one of the most stressful events in the life of a parent. We hypothesized that parental bereavement increases the risk of hospital admission for a psychiatric disorder, especially for affective disorders. METHODS: We studied a cohort of 1,082,503 persons identified from national registers in Denmark who were born between 1952 and 1999 and had at least one child under 18 years of age during the follow-up period, from 1970 to 1999. Parents who lost a child during follow-up were categorized as "bereaved" from the date of death of the child. RESULTS: As compared with parents who did not lose a child, parents who lost a child had an overall relative risk of a first psychiatric hospitalization for any disorder of 1.67 (95 percent confidence interval, 1.53 to 1.83). Bereaved mothers had a higher relative risk of being hospitalized for any psychiatric disorder than bereaved fathers (relative risks, 1.78 [95 percent confidence interval, 1.60 to 1.98] and 1.38 [95 percent confidence interval, 1.17 to 1.63], respectively; P value for interaction, 0.01). The relative risks of hospitalization specifically for affective disorders were 1.91 (95 percent confidence interval, 1.59 to 2.30) and 1.61 (95 percent confidence interval, 1.15 to 2.27) for bereaved mothers and fathers, respectively. Among mothers, the relative risk of being hospitalized for any psychiatric disorder was highest during the first year after the death of the child but remained significantly elevated five years or more after the death. CONCLUSIONS: The risk of psychiatric hospitalization was increased among parents, especially mothers, who lost a child.
2005
Li J; Laursen TM; Precht DH; Olsen J; Mortensen PB
The New England Journal Of Medicine
2005
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Journal Article
<a href="http://doi.org/10.1056/NEJMoa033160" target="_blank" rel="noreferrer">10.1056/NEJMoa033160</a>
Mortality in parents after death of a child in Denmark: A nationwide follow-up study.
Child; Female; Humans; Male; Adult; Follow-Up Studies; Death; Health Status; Longitudinal Studies; Risk Factors; Life Change Events; Time Factors; Incidence; Proportional Hazards Models; Registries; Population Surveillance; adolescent; Preschool; bereavement; infant; cause of death; Denmark/epidemiology; Parents/psychology; Sex Distribution; mortality; SSHRC CURA
BACKGROUND: Little is known about the effect of parental bereavement on physical health. We investigated whether the death of a child increased mortality in parents. METHODS: We undertook a follow-up study based on national registers. From 1980 to 1996, we enrolled 21062 parents in Denmark who had a child who had died (exposed cohort), and 293745 controls--ie, parents whose children were alive, and whose family structure matched that of the exposed cohort. Natural deaths were defined with ICD8 codes 0000-7969 and ICD10 codes A00-R99, and unnatural deaths with codes 8000-9999 and V01-Y98. We used Cox's proportional-hazards regression models to assess the mortality rate of parents up to 18 years after bereavement. FINDINGS: We observed an increased overall mortality rate in mothers whose child had died (hazards ratio 1.43, 95% CI 1.24-1.64; p<0.0001). An excess mortality from natural causes (1.44, 1.15-1.78; p<0.0001) was noted in mothers only during the 10th-18th year of follow-up. Mothers had increased mortality rates from unnatural causes throughout follow-up, with the highest rate recorded during the first 3 years (3.84, 2.48-5.88; p<0.0001). Bereaved fathers had only an early excess mortality from unnatural causes (1.57, 1.06-2.32; p=0.04). Mothers who lost a child due to an unnatural death or an unexpected death had a hazard ratio of 1.72 (1.38-2.15; p=0.0040) and 1.67 (1.37-2.03; p=0.0037), respectively. INTERPRETATION: The death of a child is associated with an overall increased mortality from both natural and unnatural causes in mothers, and an early increased mortality from unnatural causes in fathers.
2003
Li J; Precht DH; Mortensen PB; Olsen J
Lancet
2003
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Journal Article
<a href="http://doi.org/10.1016/s0140-6736(03)12387-2" target="_blank" rel="noreferrer">10.1016/s0140-6736(03)12387-2</a>
Association of Mortality With the Death of a Sibling in Childhood.
Bereavement; Mortality; Siblings; Adolescent; Age Factors; Cause Of Death; Child; Child, Preschool; Denmark/epidemiology; Family Health/ Statistics & Numerical Data; Female; Follow-up Studies; Humans; Life Change Events; Male; Registries; Risk Factors; Sex Factors; Sweden/epidemiology; Time Factors
Importance: The death of a close relative is associated with an increased mortality risk among the bereaved, but much less is known about the potential association of the death of a sibling in childhood with mortality in this population. Objective: To examine the association between sibling death in childhood and subsequent mortality risk. Design, Setting, and Participants: This population-based cohort study of 5005029 participants evaluated linked national registers in Denmark (January 1, 1973, through December 31, 2009) and Sweden (January 1, 1973, through December 31, 2008). A total of 2060354 Danish and 2944675 Swedish children who survived the first 6 months of their life were included. We excluded 14 children who died of the same external cause as their siblings within 30 days. Data were analyzed from November 2, 2015, through October 14, 2016. Exposures: Participants were classified as exposed if a sibling died in childhood (age <18 years). Main Outcomes and Measures: Poisson regression was used to estimate mortality rate ratio (MRR) with the exposure as a time-varying variable. Results: Among the 55 818 participants who experienced sibling death in childhood (51.5% male and 48.5% female; median age at loss, 7.0 [interquartile range, 3.3-12.1] years), all-cause mortality risk was increased by 71% (MRR, 1.71; 95% CI, 1.57-1.87) during the follow-up of 37 years. The excess mortality risk was observed for groups with specific causes of death, and the higher MRRs were found when the sibling pairs died of the same cause (death due to disease [MRR, 2.16; 95% CI, 1.87-2.49]; death due to external cause [MRR, 1.91; 95% CI, 1.54-2.37]). The increased mortality risk after sibling death was seen across the follow-up period, regardless of the age at bereavement and the type of death among bereaved siblings, but the magnitude of association was stronger during the first year after sibling death (MRR, 2.51; 95% CI, 1.79-3.54). Higher MRRs were found among sibling pairs with the same sex (MRR, 1.92; 95% CI, 1.70-2.18) and close age (MRR, 1.94; 95% CI, 1.58-2.37). Conclusions and Relevance: Bereavement in childhood because of the death of a sibling was associated with an increased risk for mortality in the short and long term. Health care professionals should be aware of individuals' vulnerability due to sibling death, especially for sibling pairs of close age or the same sex. Social and health care support may help to minimize the potential adverse effects on the bereaved sibling.
Yu Y; Liew Z; Cnattingius S; Olsen J; Vestergaard M; Fu B; Parner ET; Qin G; Zhao N; Li J
Jama Pediatrics
2017
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<a href="https://doi.org/10.1001/jamapediatrics.2017.0197" target="_blank" rel="noreferrer">10.1001/jamapediatrics.2017.0197</a>