Death of a child and the risk of atrial fibrillation: a nationwide cohort study in Sweden

Wei, Dang; Olofsson, Tristan; Chen, Hua; Janszky, Imre; Fang, Fang; Ljung, Rickard; Yu, Yongfu; Li, Jiong; László, Krisztina D.

doi:10.1093/eurheartj/ehaa1084

Cited by 17 publications

(87 citation statements)

References 38 publications

(25 reference statements)

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“…We studied parents of live-born children included in the Danish Medical Birth Register (MBR) during 1973 to 2016 ( n = 2,807,548) and in the Swedish MBR during 1973 to 2014 ( n = 3,924,237) [ 11 ]. Children registered in the MBRs were linked to their parents by means of the Civil Registration System in Denmark and the Multi-Generation Register in Sweden.…”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“…To obtain information on parents and their family members, we linked the cohort to several other registers ( S1 Table ) using the unique personal identification number [ 11 ]. Since the coverage of the Danish National Hospital Register became complete in 1978 and that of the Swedish Patient Register in 1987, we defined the study period as 1978 to 2016 for the Danish and 1987 to 2014 for the Swedish parents [ 11 ]. Parents entered the cohort at the start of the study period (January 1, 1978 in Denmark and January 1, 1987 in Sweden) if they had at least 1 child at that time, otherwise on the date of birth of the first child in Denmark/Sweden or upon immigration with child(ren) to these countries, whichever came later during the study period ( S1 Fig ).…”

Section: Methodsmentioning

confidence: 99%

“…An increasing number of studies have suggested that the death of a spouse in middle and old age may increase the risk of cardiovascular mortality [ 1 – 4 ], particularly in the months following the loss [ 1 , 3 ]. Knowledge about the effect of bereavement on incident cardiovascular diseases (CVDs) and of other types of losses is much more limited, though recently, a few studies have reported associations between the death of a spouse, a sibling, a child, or “a significant person” and increased risks of acute myocardial infarction (AMI), stroke, atrial fibrillation, and/or cardiovascular mortality [ 5 – 11 ].…”

Section: Introductionmentioning

confidence: 99%

“…Accepting the loss of a child—a task that according to several theories of bereavement is the most important for grief resolution—is very difficult for parents [ 14 ], as child mortality is very low in Western societies and is in sharp contrast with expectations about the life cycle. Parental grief is unusually intense and persistent and can hardly be fully resolved [ 11 , 15 ]. The loss of a child is more likely to result in complicated grief than the loss of other family members [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2021

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Background 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. Methods and findings 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. Conclusions 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.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2021

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Sibling Death in Childhood and Early Adulthood and Risk of Early-Onset Cardiovascular Disease

Huang,

Peng,

Lee

et al. 2024

JAMA Netw Open

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ImportanceSibling death is a highly traumatic event, but empirical evidence on the association of sibling death in childhood and early adulthood with subsequent risk of incident cardiovascular disease (CVD) remains limited.ObjectiveTo evaluate the association between sibling death in the early decades of life and subsequent risk of incident early-onset CVD.Design, Setting, and ParticipantsThis population-based cohort study included 2 098 659 individuals born in Denmark from 1978 to 2018. Follow-up started at age 1 year or the date of the first sibling’s birth, whichever occurred later, and it ended at the first diagnosis of CVD, the date of death, emigration, or December 31, 2018, whichever came first. Data analyses were conducted from November 1, 2021, through January 10, 2022.ExposuresThe death of a sibling.Main Outcomes and MeasuresThe outcome was early-onset CVD. Cox models were used to estimate hazard ratios (HRs) with 95% CIs.ResultsThis study included 2 098 659 individuals (1 076 669 [51.30%] male; median [IQR] age at death of sibling, 11.48 [4.68-21.32] years). During the median (IQR) follow-up of 17.52 (8.85-26.05) years, 1286 and 76 862 individuals in the bereaved and nonbereaved groups, respectively, were diagnosed with CVD. Sibling death in childhood and early adulthood was associated with a 17% increased risk of overall CVD (HR, 1.17; 95% CI, 1.10-1.23; cumulative incidence in bereaved individuals, 1.96% [1.61%-2.34%]; cumulative incidence in nonbereaved individuals at age 41 years, 1.35% [1.34%-1.37%]; cumulative incidence difference: 0.61% [95% CI, 0.24%-0.98%]). Increased risks were also observed for most type-specific CVDs, in particular for myocardial infarction (HR, 1.66; 95% CI, 1.12-2.46), ischemic heart disease (HR, 1.52; 95% CI, 1.22-1.90), and heart failure (HR, 1.50; 95% CI, 1.00-2.26). The association was observed whether the sibling died due to CVD (HR, 2.54; 95% CI, 2.04-3.17) or non-CVD (HR, 1.13; 95% CI, 1.06-1.19) causes. The increased risk of CVD was more pronounced for individuals who lost a twin or younger sibling (HR, 1.25; 95% CI, 1.15-1.36) than an elder sibling (HR, 1.11; 95% CI, 1.03-1.20).Conclusions and RelevanceIn this cohort study of the Danish population, sibling death in childhood and early adulthood was associated with increased risks of overall and most type-specific early-onset CVDs, with the strength of associations varying by cause of death and age difference between sibling pairs. The findings highlight the need for extra attention and support to the bereaved siblings to reduce CVD risk later in life.

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Risk of cardiovascular disease among parents of children diagnosed with cancer: a population‐based study from Denmark and Sweden

Liu

László

Wei

et al. 2023

Cancer Communications

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Death of a child and the risk of atrial fibrillation: a nationwide cohort study in Sweden

Cited by 17 publications

References 38 publications

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

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

Sibling Death in Childhood and Early Adulthood and Risk of Early-Onset Cardiovascular Disease

Risk of cardiovascular disease among parents of children diagnosed with cancer: a population‐based study from Denmark and Sweden

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