Cited by 213Maternal Mental Health During Pregnancy and PostpartumGrief, Bereavement, and Mental HealthFamily Support in Illness

Offspring psychopathology following preconception, prenatal and postnatal maternal bereavement stress

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Class, Q. A., Abel, K. M., Khashan, A. S., Rickert, M. E., Dalman, C., Larsson, H., Hultman, C. M., Långström, N. +2 more·2014·Psychological Medicine

Abstract

Background: Preconception, prenatal and postnatal maternal stress is associated with increased offspring psychopathology, but findings are inconsistent and need replication. We estimated associations between maternal bereavement stress and offspring autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), bipolar disorder, schizophrenia, suicide attempt and completed suicide. Method: Using Swedish registers, we conducted the largest population-based study to date examining associations between stress exposure in 738 144 offspring born 1992–2000 for childhood outcomes and 2 155 221 offspring born 1973–1997 for adult outcomes with follow-up to 2009. Maternal stress was defined as death of a first-degree relative during ( a ) the 6 months before conception, ( b ) pregnancy or ( c ) the first two postnatal years. Cox proportional survival analyses were used to obtain hazard ratios (HRs) in unadjusted and adjusted analyses. Results: Marginal increased risk of bipolar disorder and schizophrenia following preconception bereavement stress was not significant. Third-trimester prenatal stress increased the risk of ASD [adjusted HR (aHR) 1.58, 95% confidence interval (CI) 1.15–2.17] and ADHD (aHR 1.31, 95% CI 1.04–1.66). First postnatal year stress increased the risk of offspring suicide attempt (aHR 1.13, 95% CI 1.02–1.25) and completed suicide (aHR 1.51, 95% CI 1.08–2.11). Bereavement stress during the second postnatal year increased the risk of ASD (aHR 1.30, 95% CI 1.09–1.55). Conclusions: Further research is needed regarding associations between preconception stress and psychopathological outcomes. Prenatal bereavement stress increases the risk of offspring ASD and ADHD. Postnatal bereavement stress moderately increases the risk of offspring suicide attempt, completed suicide and ASD. Smaller previous studies may have overestimated associations between early stress and psychopathological outcomes.

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  • A large registry study from Sweden reported that third trimester prenatal stress increased ASD risk (OR 1.58, 95% CI 1.15-2.17).

    “A large registry study from Sweden, not included in the review, reported that third trimester prenatal stress increased ASD risk (OR 1.58, 95% CI 1.15–2.17) [226].”

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Authors
Class, Q. A., Abel, K. M., Khashan, A. S., Rickert, M. E., Dalman, C., Larsson, H., Hultman, C. M., Långström, N., Lichtenstein, P., & D‘Onofrio, B. M.
Affiliations
  • Indiana University Bloomington (US)
  • University of Manchester (GB)
  • University College Cork (IE)
  • Karolinska Institutet (SE)
Corresponding author
Class, Q. A.
Venue
Psychological Medicine
Published
2013-04-17
Volume
44
Issue
1
Pages
71-84
ISSN
  • 0033-2917 (ISSN-L)
  • 1469-8978
OpenAlex
W2119320045
Cited by
213
References
87
Citations by year
2026: 10 · 2025: 16 · 2024: 17 · 2023: 13 · 2022: 22 · 2021: 19 · 2020: 13 · 2019: 24 · 2018: 20 · 2017: 11 · 2016: 16 · 2015: 18 · 2014: 12 · 2013: 2
FWCI
16.32
Type
journal article
Language
en
Open access
Locations
  • Psychological Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • Research Explorer (The University of Manchester) (submittedVersion)
Funders
  • National Institute for Health and Care Research
  • Forskningsrådet för Arbetsliv och Socialvetenskap
  • Vetenskapsrådet
  • Svenska Läkaresällskapet
  • National Institutes of Health
  • National Institute of Mental Health (F31MH094011, MH 094011)
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD061817, HD061817)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
  • Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
  • Social Sciences › Sociology and Political Science › Family Support in Illness
Keywords
offspring psychopathology, autism spectrum disorder, attention deficit hyperactivity disorder, bipolar disorder, schizophrenia, suicide attempts, suicide mortality, prenatal stress, postpartum stress, offspring mental health
MeSH terms
Adolescent, Adult, Attention Deficit Disorder with Hyperactivity, Mental Disorders, Bereavement, Bipolar Disorder, Child, Child Development Disorders, Pervasive, Female, Humans, Male, Mothers, Pregnancy, Pregnancy Complications, Prenatal Exposure Delayed Effects, Risk Factors, Schizophrenia, Stress, Psychological, Suicide, Suicide, Attempted, Sweden, Proportional Hazards Models, Databases, Factual, Maternal Exposure, Postpartum Period, Young Adult

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