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Prenatal Maternal Bereavement and Its Association With Intellectual Disability in the Offspring
Xiujuan Su1, Yongfu Yu, Lulu Meng
1From the Clincial Research Centre, Shanghai First Maternity and Infant Hospital (Su), School of Medicine, Tongji University, China; Department of Clinical Medicine-Department of Clinical Epidemiology (Yu, Li), Aarhus University Hospital, Aarhus, Denmark; Department of Biostatistics, School of Public Health, and The Key Laboratory of Public Health Safety of Ministry of Education (Yu), Fudan University; Department of Obstetrics, Shanghai First Maternity and Infant Hospital (Meng, Duan), School of Medicine, Tongji University, Shanghai, China; Clinical and Translational Research Center, Shanghai First Maternity and Infant Hospital (Zhao), School of Medicine, Tongji University, Shanghai, China; Department of Public Health Sciences (László), Karolinska Institutet, Stockholm, Sweden; Centre for Public Health Sciences (Valdimarsdóttir), University of Iceland, Reykjavik, Iceland; Department of Medical Epidemiology and Biostatistics (Valdimarsdóttir), Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology (Valdimarsdóttir), Harvard TH Chan School of Public Health, Boston, Massachusetts; Department of Women & Children's Health Care, Shanghai First Maternity and Infant Hospital (Hua), School of Medicine, Tongji University; and Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital (Li), Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Objective:
This study aimed to examine the association of a mother's loss of a close relative before or during pregnancy with intellectual disability (ID) in the offspring.
Methods:
We performed a nationwide population-based cohort study based on Danish national registries. All live-born singletons born in Denmark during the 1978-2016 period (n = 2,216,601) were followed up starting from birth to 38 years of age. Log-linear Poisson regression was used to estimate the association between maternal bereavement (the death of an older child, a partner, or a parent 1 year before or during pregnancy) and the risk of ID in the offspring.
Results:
Maternal bereavement during or before pregnancy was associated with an increased risk of ID (incidence rate ratio [IRR] = 1.15; 95% confidence interval [CI] = 1.04-1.28). The risk of ID was increased by 27% when maternal bereavement occurred during pregnancy (IRR = 1.27; 95% CI = 1.08-1.49). When stratifying on the child's sex, we also observed an increased risk of ID associated with maternal bereavement during pregnancy both for male (IRR = 1.25; 95% CI = 1.02-1.53) and for female (IRR = 1.31; 95% CI = 1.02-1.69), respectively. The IRRs for unnatural death of a relative were also elevated (IRR = 1.22; 95% CI = 0.91-1.64) in general, although the difference was not statistically significant.
Conclusions:
Our findings suggest that prenatal stress due to maternal loss of a close relative may increase the risk of offspring's ID of both sexes, in particular when the loss happened during pregnancy.
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