Bereavement over loss of child linked to increased stroke risk

Bereavement-related stress, particularly from the death of a child, may slightly increase risk for stroke, according to a bi-national, population-based cohort study published in Neurology.

“Increasing evidence suggests that parents who experience the death of a child have higher risks of morbidity and mortality, including acute myocardial infarction, ischemic heart disease, atrial fibrillation, heart failure and cardiovascular death than their unexposed counterparts,” Dang Wei, MD, MSc, of the department of global public health at the Karolinska Institutet in Sweden, and colleagues wrote. “A recent systematic review suggests that the death of a close family member is associated with an increased risk of stroke; however, the majority of the six studies included in the review focused on spousal bereavement.”

Researchers sought to investigate whether parents who lost a child have an increased risk for stroke, given that mounting evidence suggests the impact of such life-changing events leaves parents at greater risk for long-term health issues, including cardiovascular disease.

Wei and colleagues studied parents who had a child born and recorded in the Danish and Swedish medical birth registers between 1973 and2016 and 1973 and2014, respectively. They also reviewed information on child’s death, parent’s stroke and other socioeconomic and health-related factors through population-based registers and used Poisson regression to evaluate the correlation between death of a child and risk for stroke.

According to study results, among 6,711,955 study participants, 128,744 (1.9%) experienced the death of a child and 141,840 (2.1%) had a stroke during follow-up. Based on these findings, Wei and colleagues determined that bereaved parents were at greater risk for stroke, noting an association between parental grief and stroke risk for all categories of causes of child death; the age of the deceased child did not appear to significantly contribute to the parents’ risk for stroke.

Further, researchers found that the association was stronger if the parent had either no children or at least 3 or more children alive, as opposed to just one or two living children at the time of the loss; these finding were similar for both ischemic and hemorrhagic stroke.

In addition, Wei and colleagues noted that the associations between the death of a child and all types of stroke were stronger for parents younger than age 50 years, and mothers were more likely to experience hemorrhagic stroke than fathers. Data also revealed that the risk for hemorrhagic stroke was highest immediately after the death of a child and decreased thereafter. Conversely, researchers observed no clear pattern regarding level of risk over time for ischemic stroke.

“Our findings are in line with several earlier studies showing a 9% to 140% increased risk of stroke in persons exposed to the death of a spouse, sibling or an unspecified relative,” Wei and colleagues wrote. “Similarly, our results are also comparable to associations reported between other psychosocial factors, such as work stress, anxiety, and depression and the risk of stroke.”