There has been no clear evidence to suggest that the death of a child is associated with an increased mortality rate among surviving parents. Jørn Olsen and colleagues from the University of Aarhus, Denmark, used data from Danish death registries from 1980-96 to assess whether child death was linked to an increased risk of parental death compared with parents who had not experienced death of a child. Around 20,000 parents who had experienced death of a child were compared with a control population of 293,000 parents whose children were alive. Parents were followed-up for a maximum of 18 years.
Mothers were around 40% more likely to die within 18 years after death of a child compared with mothers whose children remained alive. Death of a child from unnatural causes increased mothers' death rate by 40% compared with mothers whose children had died from natural causes. This association was most striking in the first three years after the child's death-here the mother's death rate increased almost fourfold. Mothers who had experienced death of a child only had an increased risk of death from natural causes such as cancer or cardiovascular disease 10 or more years after the death of their child. Fathers were much less affected, with a relative increased mortality risk of around 60% soon after the death of their child.
The investigators focus on increased stress among parents after child death as the main underlying cause of the increased death rates. Jørn Olsen comments: "Psychological stress after the death of a child could affect health outcomes in several ways. The most intense reactions are often seen shortly after the bereavement, with a short-term peak of mortality from unnatural causes. In the long term, various pathophysiological changes related to stress could increase susceptibility to infectious diseases, affect the risk and prognosis of cancer, and lead to diseases of the cardiovascular systems. Stress also affects lifestyle-eg, by increasing smoking and alcohol intake, altering dietary patterns, and reducing physical activity-which could increase the risk of mortality from both natural and unnatural causes…Our results showed that, overall, the death of a child aged younger than 18 years increased maternal mortality from all causes, but especially unnatural ones. Bereaved fathers, however, were at increased risk of death from unnatural causes alone, and only for a short period after the death of their child."
Contact: Dr Jørn Olsen, The Danish Epidemiology Science Centre, University of Aarhus, Vennelyst Boulevard 6, DK-8000 Aarhus C, Denmark; T) +45 8942 6085; F) +45 8613 1580; E) jo@soci.au.dk
Journal
The Lancet