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子女夭折后父母的死亡率。

Mortality in parents after the death of a child.

机构信息

Waisman Center, University of Wisconsin, Madison, USA.

Department of Psychology, University of Hawaii at Manoa, USA.

出版信息

Soc Sci Med. 2019 Oct;239:112522. doi: 10.1016/j.socscimed.2019.112522. Epub 2019 Aug 28.

Abstract

OBJECTIVE

The death of a child is a traumatic stressor that takes a toll on the health of parents. This study examined long-term impacts of the death of a child on the risk of early mortality in bereaved parents. In a follow-up analysis, a twin subsample was analyzed to examine potential genetic confounding.

METHOD

We analyzed data from the Midlife in the United States (MIDUS) study. The primary sample consists of two groups of MIDUS 2 participants (2004-06); (1) parents who experienced the death of a child prior to MIDUS 2 (n = 451) and (2) comparison parents who had not experienced death of any children (n = 1804) (mean age = 63). We also analyzed 52 twin pairs in which one twin experienced the death of a child and 271 twin pairs in which both twins had all living children. Mortality status of parents was assessed in 2017.

RESULTS

Parents who had experienced the death of a child had a 32% higher likelihood of early mortality (defined as dying earlier than life expectancy) than their peers who did not have any deceased children, and they were more likely to die of heart disease. Analyses of the twin subsample revealed significantly lower concordance for early mortality among the pairs with a bereaved twin than among control twins, consistent with non-genetic effects.

CONCLUSIONS

The findings suggest that the death of a child has lasting impacts on the risk of early mortality in bereaved parents. This study provides the first U.S. estimate of bereavement effects on mortality extending through the parents' full life course, with significant public health implications. In addition, analysis of concordance of early death rates in the twin subsample suggests the impact on mortality of parental bereavement, net of genetic factors.

摘要

目的

儿童死亡是一个创伤性的应激源,会对父母的健康造成影响。本研究探讨了儿童死亡对丧亲父母早期死亡风险的长期影响。在一项后续分析中,对双胞胎子样本进行了分析,以检验潜在的遗传混杂因素。

方法

我们分析了美国中年生活研究(MIDUS)的数据。主要样本由 MIDUS 2 两个参与者组组成;(1)在 MIDUS 2 之前经历过孩子死亡的父母(n=451)和(2)没有经历过任何孩子死亡的对照组父母(n=1804)(平均年龄=63)。我们还分析了 52 对双胞胎中的一个双胞胎经历了孩子死亡,以及 271 对双胞胎中的两个双胞胎都有所有活着的孩子。2017 年评估了父母的死亡状态。

结果

与没有已故子女的同龄人相比,经历过孩子死亡的父母早期死亡(定义为早于预期寿命死亡)的可能性高出 32%,而且他们死于心脏病的可能性更高。对子样本的分析表明,在有丧亲双胞胎的对子中,早期死亡率的一致性明显低于对照组双胞胎,这与非遗传因素一致。

结论

这些发现表明,孩子的死亡对丧亲父母的早期死亡风险有持久的影响。本研究提供了美国首例关于丧亲对死亡率影响的估计,该影响延伸到父母的整个生命周期,具有重要的公共卫生意义。此外,对子样本中早期死亡率一致性的分析表明,父母丧亲对死亡率的影响,扣除遗传因素。

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