Maternal Antenatal Bereavement and Neural Tube Defect in Live-Born Offspring: A Cohort Study

Area of Science:

• Reproductive epidemiology
• Developmental biology
• Perinatal mental health

Background:

• Maternal emotional stress during pregnancy is linked to congenital neural malformations.
• Previous studies often rely on retrospective data.
• The impact of antenatal maternal bereavement on neural tube defects (NTDs) requires further investigation.

Purpose of the Study:

• To investigate the association between antenatal maternal bereavement and NTDs in offspring.
• To examine the risk of NTDs following the loss of a close relative during the sensitive period of early pregnancy.

Main Methods:

• A large register-based cohort study of 1,734,190 live-born children (1978-2008).
• Exposure defined as bereavement due to loss of a close relative from one year pre-conception to the end of the first trimester.
• NTDs in offspring identified via the International Classification of Disease; multivariate logistic regression used to estimate prevalence odds ratios (ORs).

Main Results:

• 2% of children were born to mothers experiencing prenatal bereavement.
• 1,115 children diagnosed with NTDs (spina bifida, anencephaly, encephalocele) during 30 years of follow-up.
• No significant increase in NTD prevalence was observed in offspring of bereaved mothers (OR = 0.84; 95% CI: 0.52-1.33).

Conclusions:

• Antenatal maternal bereavement was not associated with an increased prevalence of neural tube defects in liveborn offspring.
• These findings contribute to understanding the impact of severe stress on pregnancy outcomes.