From the Department of Global Public Health (Chen, Forsell, Janszky, László), Karolinska Institutet; Department of Public Health Sciences (Hemmingsson, Rostila), Stockholm University; Institute of Environmental Medicine (Hemmingsson), Karolinska Institutet; Centre for Epidemiology and Community Medicine (Forsell), Stockholm County Council, Stockholm; Centre for Health Equity Studies (Rostila), Stockholm University/Karolinska Institutet, Stockholm, Sweden; and Department of Public Health and General Practice, Faculty of Medicine (Janszky), Norwegian University of Science and Technology, Trondheim, Norway.
Psychosom Med. 2020 Nov/Dec;82(9):810-816. doi: 10.1097/PSY.0000000000000861.
The death of a parent during childhood is a severe life event with potentially long-term consequences. Earlier studies have shown an increased risk of cardiovascular diseases (CVD) after the death of a spouse, child, or sibling. Whether parental death during childhood is associated with an increased risk of incident CVD is unknown and was investigated in this study.
We studied 48,992 men born 1949 to 1951 and enlisted for military conscription in 1969 to 1970. We obtained information on death of a parent during childhood, CVD up to 2008, and covariates by linking the questionnaire and the clinical examination data from conscription with nationwide socioeconomic and health registers.
Men who lost a parent during childhood had an increased risk of ischemic heart disease (IHD; adjusted hazard ratio (HR) and 95% confidence interval [CI] = 1.30 [1.13-1.49]) but not of stroke during the 39-year follow-up (adjusted HR [95% CI] = 0.87 [0.66-1.15]). Maternal death was associated with IHD both when the loss was due to cardiovascular (adjusted HR [95% CI] = 2.04 [1.02-4.08]) and unnatural causes (adjusted HR [95% CI] = 2.50 [1.42-4.42]); in case of paternal death, an increased IHD risk was observed only when the loss was due to cardiovascular causes (adjusted HR [95% CI] = 1.82 [1.37-2.42]). There were no substantial differences in CVD according to the child's age at the loss.
Parental death during childhood was associated with an increased risk of IHD in men. If these associations are confirmed in future studies, the long-term effects of childhood bereavement may warrant attention.
儿童期父母一方的离世是一种严重的生活事件，可能会带来长期后果。早期研究表明，丧偶、子女或兄弟姐妹去世后，心血管疾病（CVD）的风险会增加。儿童期父母一方的离世是否与 CVD 发病风险增加有关尚不清楚，本研究对此进行了调查。
我们研究了 1949 年至 1951 年出生的 48992 名男性，他们于 1969 年至 1970 年应征入伍。我们通过将征兵问卷和临床检查数据与全国社会经济和健康登记处进行链接，获取了儿童期父母一方离世、CVD 直至 2008 年的信息以及协变量信息。
在 39 年的随访期间，失去父母一方的男性患缺血性心脏病（IHD；调整后的危险比（HR）和 95%置信区间[CI] = 1.30 [1.13-1.49]）的风险增加，但患中风的风险并未增加（调整后的 HR [95% CI] = 0.87 [0.66-1.15]）。母亲去世与心血管原因（调整后的 HR [95% CI] = 2.04 [1.02-4.08]）和非自然原因（调整后的 HR [95% CI] = 2.50 [1.42-4.42]）导致的 IHD 均有关联；而父亲去世仅与心血管原因导致的 IHD 风险增加有关（调整后的 HR [95% CI] = 1.82 [1.37-2.42]）。在儿童失去父母一方时的年龄方面，CVD 没有明显差异。
儿童期父母一方的离世与男性患 IHD 的风险增加有关。如果这些关联在未来的研究中得到证实，那么儿童期丧亲的长期影响可能需要引起关注。
