Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
J Epidemiol Community Health. 2023 May;77(5):322-327. doi: 10.1136/jech-2022-219695. Epub 2023 Mar 1.
Several studies suggest that bereavement is associated with increased risks of ischaemic heart disease, heart failure, stroke and cardiovascular mortality. Knowledge regarding the link between bereavement and the risk of atrial fibrillation (AF) is limited. We investigated whether the death of a child, one of the most severe forms of bereavement, is associated with AF.
We conducted a population-based cohort study involving parents of live-born children during 1973-2016 from the Danish Medical Birth Register (n=2 804 244). Information on children's death, parental AF and sociodemographic and other health-related characteristics was obtained by individual-level linkage between several Danish population-based registers. We analysed the association between loss of a child and AF using Poisson regression.
During the up to 39 years follow-up, 64 216 (2.3%) parents lost a child and 74 705 (2.7%) had an AF. Bereaved parents had a higher risk of AF than the non-bereaved; the corresponding incidence rate ratio (IRR) and 95% CI were 1.12 (1.08 to 1.17). The association was present both when the child died of cardiovascular diseases (IRR (95% CI): 1.42 (1.20 to 1.69)), and of other causes (IRR (95% CI): 1.11 (1.06 to 1.16)), tended to be U-shaped according to the deceased child's age at loss, but did not differ substantially according to the number of remaining live children at loss, the number of deceased children or the time since the loss.
The death of a child was associated with a modestly increased risk of AF. Bereaved parents may benefit from increased support from family members and health professionals.
多项研究表明,丧偶与缺血性心脏病、心力衰竭、中风和心血管死亡率增加有关。关于丧偶与心房颤动(AF)风险之间联系的知识有限。我们研究了孩子的死亡(最严重的丧偶形式之一)是否与 AF 相关。
我们进行了一项基于人群的队列研究,涉及 1973 年至 2016 年期间丹麦医疗出生登记处(n=2 804 244)活产子女的父母。通过将几个丹麦人口登记处进行个体层面的链接,获取关于孩子死亡、父母 AF 以及社会人口统计学和其他与健康相关的特征的信息。我们使用泊松回归分析了失去孩子与 AF 之间的关联。
在长达 39 年的随访期间,64216 名(2.3%)父母失去了孩子,74705 名(2.7%)父母患有 AF。丧偶父母患 AF 的风险高于未丧偶父母;相应的发病率比(IRR)和 95%CI 为 1.12(1.08 至 1.17)。当孩子死于心血管疾病(IRR(95%CI):1.42(1.20 至 1.69))和其他原因(IRR(95%CI):1.11(1.06 至 1.16))时,这种关联都存在,并且根据失去孩子时的年龄呈 U 型趋势,但与失去时剩余的活孩子数量、死亡孩子数量或失去后时间长短差异不大。
孩子的死亡与 AF 风险略有增加相关。丧偶父母可能受益于家庭成员和卫生专业人员的更多支持。