Loss of a close family member the year before or during pregnancy and the risk of placental abruption: a cohort study from Denmark and Sweden
Abstract
BACKGROUND: Maternal stress during pregnancy is associated with a modestly increased risk of fetal growth restriction and pre-eclampsia. Since placental abruption shares similar pathophysiological mechanisms and risk factors with fetal growth restriction and pre-eclampsia, we hypothesized that maternal stress may be implicated in abruption risk. We investigated the association between maternal bereavement during pregnancy and placental abruption. METHOD: We studied singleton births in Denmark (1978-2008) and Sweden (1973-2006) (n = 5,103,272). In nationwide registries, we obtained data on death of women's close family members (older children, siblings, parents, and partners), abruption and potential confounders. RESULTS: A total of 30,312 (6/1000) pregnancies in the cohort were diagnosed with placental abruption. Among normotensive women, death of a child the year before or during pregnancy was associated with a 54% increased odds of abruption [95% confidence interval (CI) 1.30-1.82]; the increased odds were restricted to women who lost a child the year before or during the first trimester in pregnancy. In the group with chronic hypertension, death of a child the year before or in the first trimester of pregnancy was associated with eight-fold increased odds of abruption (odds ratio 8.17, 95% CI 3.17-21.10). Death of other relatives was not associated with abruption risk. CONCLUSIONS: Loss of a child the year before or in the first trimester of pregnancy was associated with an increased risk of abruption, especially among women with chronic hypertension. Studies are needed to investigate the effect of less severe, but more frequent, sources of stress on placental abruption risk.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
People who suffer from mental stress or depression, especially in the latter half of pregnancy, have an increased risk of abruption.
“People who suffer from mental stress or depression, especially in the latter half of pregnancy, also have an increased risk of abruption (45, 46).”
From Placental abruption at near-term and term gestations: Pathophysiology, epidemiology, diagnosis, and management (2023) · cites this paper as [45]
Cites
Diagnostic and Statistical Manual of Mental Disorders
Williams, J. B. W., & First, M. B. (2013) · Oxford University Press eBooks · doi:10.1093/acrefore/9780199975839.013.104 · Cited by 109,841 · see citing works
The Danish National Hospital Register. A valuable source of data for modern health sciences.
Andersen, T. F., Madsen, M., Jørgensen, J. O. L., Mellemkjoer, L., & Olsen, J. H. (1999) · PubMed · Cited by 2,034 · see citing works
Self-citationIntrauterine growth curves based on ultrasonically estimated foetal weights
Maršál, K., Persson, P., Larsen, T., Lilja, H., Selbing, A., & Sultan, B. (1996) · Acta paediatrica · doi:10.1111/j.1651-2227.1996.tb14164.x · Cited by 1,900 · see citing works
The Danish Civil Registration System. A cohort of eight million persons.
Pedersen, C. B., Gøtzsche, H., Møller, J. O., & Mortensen, P. B. (2006) · PubMed · Cited by 1,617 · see citing works
The “Great Obstetrical Syndromes” are associated with disorders of deep placentation
Brosens, I., Pijnenborg, R., Vercruysse, L., & Romero, R. (2011) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2010.08.009 · Cited by 1,568 · see citing works
Steptoe, A., Hamer, M., & Chida, Y. (2007) · Brain, Behavior, and Immunity · doi:10.1016/j.bbi.2007.03.011 · Cited by 1,278 · see citing works
A quality study of a medical birth registry
Cnattingius, S., Ericson, A., Gunnarskog, J., & Källén, B. (1990) · Scandinavian Journal of Social Medicine · doi:10.1177/140349489001800209 · Cited by 972 · cited 1× · see citing works
“A quality study of the SMBR showed that rates of placental abruption were comparable across Swedish hospitals, suggesting no substantial variability in diagnostic practices across birth centers (Cnattingius et al. 1990).”
BackgroundSelf-citationThe Danish Medical Birth Registry.
Lb, K., & Olsen, J. (1998) · PubMed · Cited by 809 · see citing works
Self-citationThe Danish Psychiatric Central Register.
Munk‐Jørgensen, P., & Mortensen, P. B. (1997) · PubMed · Cited by 703 · see citing works
When stress happens matters: Effects of earthquake timing on stress responsivity in pregnancy
Glynn, L. M., Wadhwa, P. D., Dunkel-Schetter, C., Chicz-DeMet, A., & Sandman, C. A. (2001) · American Journal of Obstetrics and Gynecology · doi:10.1067/mob.2001.111066 · Cited by 508 · see citing works
Oyelese, Y., & Ananth, C. V. (2006) · Obstetrics & Gynecology · doi:10.1097/01.aog.0000239439.04364.9a · Cited by 508 · see citing works
Self-citationJablensky, A. V., Morgan, V., Zubrick, S. R., Bower, C., & Yellachich, L.-A. (2005) · American Journal of Psychiatry · doi:10.1176/appi.ajp.162.1.79 · Cited by 505 · see citing works
Psychosocial stress increases inflammatory markers and alters cytokine production across pregnancy
Coussons-Read, M. E., Okun, M. L., & Nettles, C. D. (2007) · Brain, Behavior, and Immunity · doi:10.1016/j.bbi.2006.08.006 · Cited by 459 · see citing works
Previous Cesarean Delivery and Risks of Placenta Previa and Placental Abruption
Getahun, D., Oyelese, Y., Salihu, H. M., & Ananth, C. V. (2006) · Obstetrics & Gynecology · doi:10.1097/01.aog.0000206182.63788.80 · Cited by 449 · see citing works
Self-citationvon Känel, R., Mills, P. J., Fainman, C., & Dimsdale, J. E. (2001) · Psychosomatic Medicine · doi:10.1097/00006842-200107000-00003 · Cited by 422 · see citing works
The Swedish Medical Birth Register - a summary of content and quality
Källén, B. A. J., & Källén, K. (2003) · Lund University Publications (Lund University) · Cited by 393 · see citing works
The Health Effects of Swimming in Ocean Water Contaminated by Storm Drain Runoff
Haile, R. W., Witte, J. S., Gold, M., Cressey, R., McGee, C., Millikan, R. C., Glasser, A., Harawa, N., Ervin, C., Harmon, P., et al. (1999) · Epidemiology · doi:10.1097/00001648-199907000-00004 · Cited by 347 · see citing works
Do Stressful Life Events Affect Duration of Gestation and Risk of Preterm Delivery?
Hedegaard, M. S., Henriksen, T. B., Secher, N. J., HATCH, M. C., & Sabroe, S. (1996) · Epidemiology · doi:10.1097/00001648-199607000-00001 · Cited by 282 · see citing works
Serious life events and congenital malformations: a national study with complete follow-up
Hansen, D., Lou, H. C., & Olsen, J. (2000) · The Lancet · doi:10.1016/s0140-6736(00)02676-3 · Cited by 260 · see citing works
Self-citationClass, Q. A., Lichtenstein, P., Långström, N., & D'Onofrio, B. M. (2011) · Psychosomatic Medicine · doi:10.1097/psy.0b013e31820a62ce · Cited by 211 · see citing works
Validation of the danish birth registration
Kristensen, J. H., Langhoff‐Roos, J., Skovgaard, L. T., & Kristensen, F. B. (1996) · Journal of Clinical Epidemiology · doi:10.1016/0895-4356(96)00018-2 · Cited by 209 · see citing works
Entringer, S., Buß, C., Shirtcliff, E. A., Cammack, A. L., Yim, I. S., Chicz-DeMet, A., Sandman, C. A., & Wadhwa, P. D. (2010) · Stress · doi:10.3109/10253890903349501 · Cited by 180 · see citing works
Ethanol and the placenta: A review
Burd, L., Roberts, D. J., Olson, M. A., & Odendaal, H. J. (2007) · The Journal of Maternal-Fetal & Neonatal Medicine · doi:10.1080/14767050701298365 · Cited by 158 · see citing works
Ananth, C. V., Oyelese, Y., Prasad, V., Getahun, D., & Smulian, J. C. (2006) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2006.01.016 · Cited by 155 · see citing works
Self-citationDiagnosis of placental abruption: relationship between clinical and histopathological findings
Elsasser, D. A., Ananth, C. V., Prasad, V., & Vintzileos, A. M. (2010) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2009.10.005 · Cited by 151 · see citing works
Self-citationReduced Infant Birthweight Consequent Upon Maternal Exposure to Severe Life Events
Khashan, A. S., McNamee, R., Abel, K. M., Pedersen, M. G., Webb, R. T., Kenny, L. C., Mortensen, P. B., & Baker, P. N. (2008) · Psychosomatic Medicine · doi:10.1097/psy.0b013e318177940d · Cited by 138 · see citing works
Pregnancy affects appraisal of negative life events
Glynn, L. M., Schetter, C. D., Wadhwa, P. D., & Sandman, C. A. (2004) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(03)00133-8 · Cited by 129 · see citing works
(1986) · PubMed · Cited by 127 · see citing works
Khashan, A. S., McNamee, R., Abel, K. M., Mortensen, P. B., Kenny, L. C., Pedersen, M. G., Webb, R. T., & Baker, P. N. (2009) · Human Reproduction · doi:10.1093/humrep/den418 · Cited by 119 · see citing works
Histologic evidence of inflammation and risk of placental abruption
Nath, C. A., Ananth, C. V., Smulian, J. C., Shen‐Schwarz, S., & Kaminsky, L. M. (2007) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2007.06.012 · Cited by 103 · see citing works
Self-citationIschemic placental disease: epidemiology and risk factors
Ananth, C. V., & Vintzileos, A. M. (2011) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2011.07.025 · Cited by 99 · see citing works
Self-citationJob Strain and Pregnancy-Induced Hypertension
Marcoux, S., Bérubé, S., Brisson, C., & Mondor, M. (1999) · Epidemiology · doi:10.1097/00001648-199907000-00007 · Cited by 63 · see citing works
Timmermans, B. (2010) · VBN Forskningsportal (Aalborg Universitet) · Cited by 56 · see citing works
Severe life events and impaired fetal growth: a nation‐wide study with complete follow‐up
Precht, D. H., Andersen, P. K., & Olsen, J. (2007) · Acta Obstetricia Et Gynecologica Scandinavica · doi:10.1080/00016340601088406 · Cited by 55 · see citing works
Self-citationRisk of placental abruption in relation to maternal depressive, anxiety and stress symptoms
de Paz, N. C., Sánchez, S. E., Huaman, L. E., Chang, G. D., Pacora, P., García, P. J. G., Ananth, C. V., Qiu, C., & Williams, M. A. (2010) · Journal of Affective Disorders · doi:10.1016/j.jad.2010.07.024 · Cited by 54 · see citing works
Self-citationPsychologic factors as precursors to hypertension
Markovitz, J. H., Jonas, B. S., & Davidson, K. (2001) · Current Hypertension Reports · doi:10.1007/s11906-001-0074-y · Cited by 54 · see citing works
Cohort Profile: The Nordic Perinatal Bereavement Cohort
Li, J., Vestergaard, M., Obel, C., Cnattingus, S., Gissler, M., & Olsen, J. (2010) · International Journal of Epidemiology · doi:10.1093/ije/dyq127 · Cited by 46 · see citing works
Self-citationLászló, K. D., Liu, X., Svensson, T., Wikström, A., Li, J., Olsen, J., Obel, C., Vestergaard, M., & Cnattingius, S. (2013) · Hypertension · doi:10.1161/hypertensionaha.111.00550 · Cited by 42 · see citing works
Self-citationLászló, K. D., Svensson, T., Li, J., Obel, C., Vestergaard, M., Olsen, J., & Cnattingius, S. (2013) · American Journal of Epidemiology · doi:10.1093/aje/kws383 · Cited by 39 · see citing works
Self-citationThe effect of maternal thrombophilia on placental abruption: Histologic correlates
Kinzler, W. L., Prasad, V., Ananth, C. V., & Abrupt, F. T. N. J.-P. (2009) · The Journal of Maternal-Fetal & Neonatal Medicine · doi:10.1080/14767050802551795 · Cited by 24 · see citing works
Self-citationRydhström, H., Walles, B., & Owman, C. (1989) · PubMed · Cited by 7 · see citing works
Local Cold Stress to the Soles Induces Retroplacental Hemorrhage in Rats
Khatun, S., Kobayashi, T., Belayet, H. M., Sumimoto, K., Iwaki, T., & Kanayama, N. (2001) · Seminars in Thrombosis and Hemostasis · doi:10.1055/s-2001-14078 · Cited by 7 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Brandt, J. S., & Ananth, C. V. (2023) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2022.06.059 · Cited by 115 · see citing works
Self-citationIndependent risk factors for placental abruption: a systematic review and meta-analysis
Chen, D., Gao, X., Yang, T., Xing, X., Wang, G., Wang, H., He, R., & Liu, M. (2025) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-025-07482-7 · Cited by 19 · see citing works
Preconception Maternal Bereavement and Infant and Childhood Mortality
Class, Q. A., Mortensen, P. B., Henriksen, T. B., Dalman, C., D'Onofrio, B. M., & Khashan, A. S. (2015) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000229 · Cited by 12 · see citing works
László, K. D., Olsen, J., Li, J., Persson, M., Vestergaard, M., Svensson, T., Obel, C., & Cnattingius, S. (2015) · Paediatric and Perinatal Epidemiology · doi:10.1111/ppe.12198 · Cited by 10 · see citing works
Self-citationKawanishi, Y., Yoshioka, E., Saijo, Y., Itoh, T., Miyamoto, T., Sengoku, K., Ito, Y., Ito, S., Miyashita, C., Araki, A., et al. (2019) · PLoS ONE · doi:10.1371/journal.pone.0219379 · Cited by 11 · see citing works
László, K. D., Li, J., Olsen, J., Vestergaard, M., Obel, C., & Cnattingius, S. (2015) · Psychological Medicine · doi:10.1017/s0033291715002688 · Cited by 9 · see citing works
Self-citationAnanth, C. V., & Loh, W. W. (2022) · Epidemiology · doi:10.1097/ede.0000000000001518 · Cited by 8 · see citing works
Self-citationIn utero exposure to violence and child health in Iraq
Sardoschau, S. (2024) · Journal of Population Economics · doi:10.1007/s00148-024-01018-7 · Cited by 6 · see citing works
Lantsburg, M. E., Krysanova, T. V., & Solovyeva, E. V. (2016) · Journal of Modern Foreign Psychology · doi:10.17759/jmfp.2016050210 · Cited by 6 · see citing works
Relation of outbursts of anger and the acute risk of placental abruption: A case‐crossover study
Chahal, H. S., Gelaye, B., Mostofsky, E., Salazar, M., Sánchez, S. E., Ananth, C. V., & Williams, M. A. (2019) · Paediatric and Perinatal Epidemiology · doi:10.1111/ppe.12591 · Cited by 5 · see citing works
Self-citationTransition into and out of daylight saving time and spontaneous delivery: a population-based study
László, K. D., Cnattingius, S., & Janszky, I. (2016) · BMJ Open · doi:10.1136/bmjopen-2015-010925 · Cited by 4 · see citing works
Self-citationLászló, K. D., Johansson, S., Miao, M., Li, J., Olsen, J., Yuan, W., & Cnattingius, S. (2020) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000822 · Cited by 2 · see citing works
Self-citationAnanth, C. V., & Loh, W. W. (2024) · American Journal of Epidemiology · doi:10.1093/aje/kwae273 · Cited by 3 · see citing works
Self-citationMigration, aid, and conflict : essays in political economy and development
Sardoschau, S. (2018) · theses.fr (ABES) · doi:10.70675/89f11d36zd2e6z43b8z811dze51da84ef093
- Authors
- László, K. D., Ananth, C. V., Wikström, A. K., Svensson, T., Li, J., Olsen, J., Vestergaard, M., Obel, C., & Cnattingius, S.
- Affiliations
- Karolinska University Hospital (SE)
- Columbia University (US)
- Uppsala University (SE)
- Aarhus University (DK)
- University of California, Los Angeles (US)
- Corresponding author
- László, K. D.
- ORCID
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2013-09-26
- Volume
- 44
- Issue
- 9
- Pages
- 1855-1866
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- OpenAlex
- W2163521961
- Cited by
- 14
- References
- 42
- Citations by year
- 2025: 1 · 2024: 2 · 2023: 1 · 2022: 1 · 2020: 1 · 2019: 2 · 2018: 1 · 2016: 2 · 2015: 3
- FWCI
- 1.87
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and fetal healthcare
- Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
- Keywords
- placental abruption, maternal bereavement, death of a child, maternal stress, pregnancy, chronic hypertension, first trimester, fetal growth restriction, preeclampsia, singleton births
- MeSH terms
- Abruptio Placentae, Adult, Bereavement, Denmark, Female, Humans, Hypertension, Nuclear Family, Pregnancy, Pregnancy Complications, Registries, Stress, Psychological, Sweden, Time Factors, Cohort Studies, Parental Death
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
