Death of an offspring and parental risk of ischemic heart diseases: A population-based cohort study.

<h4>Background</h4>The death of a child is an extreme life event with potentially long-term health consequences. Knowledge about its association with ischemic heart diseases (IHDs) and acute myocardial infarction (AMI), however, is very limited. We investigated whether the death of an of...

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Autores principales:	Dang Wei, Imre Janszky, Fang Fang, Hua Chen, Rickard Ljung, Jiangwei Sun, Jiong Li, Krisztina D László
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R
Acceso en línea:	https://doaj.org/article/21dadb822dd84e57879db7b7a5cead92
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spelling	oai:doaj.org-article:21dadb822dd84e57879db7b7a5cead922021-12-02T19:56:03ZDeath of an offspring and parental risk of ischemic heart diseases: A population-based cohort study.1549-12771549-167610.1371/journal.pmed.1003790https://doaj.org/article/21dadb822dd84e57879db7b7a5cead922021-09-01T00:00:00Zhttps://doi.org/10.1371/journal.pmed.1003790https://doaj.org/toc/1549-1277https://doaj.org/toc/1549-1676<h4>Background</h4>The death of a child is an extreme life event with potentially long-term health consequences. Knowledge about its association with ischemic heart diseases (IHDs) and acute myocardial infarction (AMI), however, is very limited. We investigated whether the death of an offspring is associated with the risk of IHD and AMI.<h4>Methods and findings</h4>We studied parents of live-born children recorded in the Danish (1973 to 2016) and the Swedish (1973 to 2014) Medical Birth Registers (n = 6,711,952; mean age at baseline 31 years, 53% women). We retrieved information on exposure, outcomes, and covariates by linking individual-level information from several nationwide registers. We analyzed the abovementioned associations using Poisson regression. A total of 126,522 (1.9%) parents lost at least 1 child during the study period. Bereaved parents had a higher risk of IHD and AMI than the nonbereaved [incidence rate ratios (IRRs) (95% confidence intervals (CIs)): 1.20 (1.18 to 1.23), P < 0.001 and 1.21 (1.17 to 1.25), P < 0.001, respectively]. The association was present not only in case of losses due to CVD or other natural causes, but also in case of unnatural deaths. The AMI risk was highest in the first week after the loss [IRR (95% CI): 3.67 (2.08 to 6.46), P < 0.001], but a 20% to 40% increased risk was observed throughout the whole follow-up period. Study limitations include the possibility of residual confounding by socioeconomic, lifestyle, or health-related factors and the potentially limited generalizability of our findings outside Scandinavia.<h4>Conclusions</h4>The death of an offspring was associated with an increased risk of IHD and AMI. The finding that the association was present also in case of losses due to unnatural causes, which are less likely to be confounded by cardiovascular risk factors clustering in families, suggests that stress-related mechanisms may also contribute to the observed associations.Dang WeiImre JanszkyFang FangHua ChenRickard LjungJiangwei SunJiong LiKrisztina D LászlóPublic Library of Science (PLoS)articleMedicineRENPLoS Medicine, Vol 18, Iss 9, p e1003790 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R
spellingShingle	Medicine R Dang Wei Imre Janszky Fang Fang Hua Chen Rickard Ljung Jiangwei Sun Jiong Li Krisztina D László Death of an offspring and parental risk of ischemic heart diseases: A population-based cohort study.
description	<h4>Background</h4>The death of a child is an extreme life event with potentially long-term health consequences. Knowledge about its association with ischemic heart diseases (IHDs) and acute myocardial infarction (AMI), however, is very limited. We investigated whether the death of an offspring is associated with the risk of IHD and AMI.<h4>Methods and findings</h4>We studied parents of live-born children recorded in the Danish (1973 to 2016) and the Swedish (1973 to 2014) Medical Birth Registers (n = 6,711,952; mean age at baseline 31 years, 53% women). We retrieved information on exposure, outcomes, and covariates by linking individual-level information from several nationwide registers. We analyzed the abovementioned associations using Poisson regression. A total of 126,522 (1.9%) parents lost at least 1 child during the study period. Bereaved parents had a higher risk of IHD and AMI than the nonbereaved [incidence rate ratios (IRRs) (95% confidence intervals (CIs)): 1.20 (1.18 to 1.23), P < 0.001 and 1.21 (1.17 to 1.25), P < 0.001, respectively]. The association was present not only in case of losses due to CVD or other natural causes, but also in case of unnatural deaths. The AMI risk was highest in the first week after the loss [IRR (95% CI): 3.67 (2.08 to 6.46), P < 0.001], but a 20% to 40% increased risk was observed throughout the whole follow-up period. Study limitations include the possibility of residual confounding by socioeconomic, lifestyle, or health-related factors and the potentially limited generalizability of our findings outside Scandinavia.<h4>Conclusions</h4>The death of an offspring was associated with an increased risk of IHD and AMI. The finding that the association was present also in case of losses due to unnatural causes, which are less likely to be confounded by cardiovascular risk factors clustering in families, suggests that stress-related mechanisms may also contribute to the observed associations.
format	article
author	Dang Wei Imre Janszky Fang Fang Hua Chen Rickard Ljung Jiangwei Sun Jiong Li Krisztina D László
author_facet	Dang Wei Imre Janszky Fang Fang Hua Chen Rickard Ljung Jiangwei Sun Jiong Li Krisztina D László
author_sort	Dang Wei
title	Death of an offspring and parental risk of ischemic heart diseases: A population-based cohort study.
title_short	Death of an offspring and parental risk of ischemic heart diseases: A population-based cohort study.
title_full	Death of an offspring and parental risk of ischemic heart diseases: A population-based cohort study.
title_fullStr	Death of an offspring and parental risk of ischemic heart diseases: A population-based cohort study.
title_full_unstemmed	Death of an offspring and parental risk of ischemic heart diseases: A population-based cohort study.
title_sort	death of an offspring and parental risk of ischemic heart diseases: a population-based cohort study.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/21dadb822dd84e57879db7b7a5cead92
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Death of an offspring and parental risk of ischemic heart diseases: A population-based cohort study.

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