title: Prenatal maternal bereavement and congenital heart defects in offspring: a registry-based study.
abstract: OBJECTIVE
  It has been suggested that maternal emotional stress during cardiogenesis may be a risk factor for congenital heart defects (CHD). We examined this association using bereavement around the time of conception as an indicator of maternal exposure to stress in a large registry-based study.
  
  
  METHODS
  We identified 1,770,878 singletons born in Denmark from January 1, 1978, to December 31, 2008. Of these, 44,820 children were born to mothers who had lost a first-degree relative during the time period from 1 year before their last menstrual period until delivery (6080 mothers lost a child or partner, and 38,740 mothers lost a parent or sibling). CHD diagnoses were identified from the Danish Registry of Congenital Heart Disease. We used logistic regression models to calculate prevalence odds ratios (ORs) of CHD for exposed children compared with unexposed children.
  
  
  RESULTS
  Exposed children had a slightly higher prevalence of CHD than unexposed children (0.94% vs 0.82%; adjusted OR = 1.11, 95% confidence interval 1.00-1.22). The association was most marked for children of mothers who had lost a child or partner (1.15% vs 0.82%; adjusted OR = 1.32, 1.04-1.67).
  
  
  CONCLUSIONS
  Prenatal exposure to severe emotional stress may slightly increase the prevalence of CHD in offspring.
authors.affiliation: Research Programme for Children's Mental Health, Section of Epidemiology, Department of Public Health, Aarhus University, Bartholins Allé 2, DK 8000 Aarhus C, Denmark. zjl@soci.au.dk
authors.forename: Jin Liang
authors.initials: JL
authors.lastname: Zhu
authors.forename: Jørn
authors.initials: J
authors.lastname: Olsen
authors.forename: Henrik Toft
authors.initials: HT
authors.lastname: Sørensen
authors.forename: Jiong
authors.initials: J
authors.lastname: Li
authors.forename: Ellen A
authors.initials: EA
authors.lastname: Nohr
authors.forename: Carsten
authors.initials: C
authors.lastname: Obel
authors.forename: Mogens
authors.initials: M
authors.lastname: Vestergaard
authors.forename: Morten Smærup
authors.initials: MS
authors.lastname: Olsen
mesh_terms: D000328:Adult; D001601:Bereavement; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006330:Heart Defects, Congenital / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D006801:Humans; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D011247:Pregnancy / Q000523:psychology*; D015995:Prevalence; D012042:Registries; D012307:Risk Factors; D013315:Stress, Psychological / Q000150:complications*