Abstract
Lingering grief associated with the death of a loved one has been hypothesized to precipitate acute health events among survivors on anniversary dates. We sought to study excess mortality risk in parents around the death date and birth date of a deceased child as an indication of a "bereavement effect". We conducted a population based follow-up study using Swedish registries including links between children and parents. All biological and Swedish-born parents who experienced the death of a minor child born were observed during the period 1973-2008 (n = 48,666). An increased mortality risk was found during the week of a child's death among mothers who lost a child aged 0-17 years (SMRR = 1.46, 95% CI 0.98-2.17). The association was stronger among mothers who lost a child aged 1-17 years (SMRR = 1.89, 95% CI 0.97-3.67) as compared to those who lost an infant (SMRR = 1.29, 95% CI 0.78-2.12). Cardiovascular diseases and suicides were overrepresented as causes of death in mothers who died around the anniversary. We found no significant increase in the mortality risk around the date of child's birth, nor any suggestion of excess mortality risk among fathers, but rather a depression of paternal death (SMRR = 0.60, 95% CI 0.34-1.03). Our study indicates an anniversary reaction among mothers who lost a young child. These results suggest that bereavement per se could have an effect on health and mortality which should be acknowledged by public health professionals working with bereaved people.
Highlights
IntroductionNormally the death of parents precedes the death of children in the life cycle
In economically advanced societies, normally the death of parents precedes the death of children in the life cycle
The data consist of all biological parents to children born 1973–2008 who had experienced the death of a minor child in 1973–2008 Parents who died within 28 days after the child has died are excluded Mortality rate ratio is the ratio of the number of observed parental deaths during the specific period referred to and the expected number of parental deaths if deaths were distributed over the calendar year
Summary
Normally the death of parents precedes the death of children in the life cycle. Some studies suggest that parents suffer more intense grief after the death of a child compared to the bereavement following the death of either a spouse or a parent [2,3,4]. Studies have found that the death of a young child increases parental mortality from all causes [1], as well as the risk of depressive symptoms [10], certain types of cancer [11], myocardial infarction [12], poor self-rated health [13], diabetes [14], and suicide [15]. Some research that has examined longerterm consequences following child deaths has found that grief persists for the remainder of the parent’s life [19,20,21], while others show evidence for shorter-term consequences [22,23,24]
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