title: Reproductive function in the sons of women who experienced stress due to bereavement before and during pregnancy: a nationwide population-based cohort study.
abstract: To estimate the association between prenatal exposure to maternal stress and reproductive disorders in Danish men, where prenatal stress exposure was defined as the mother's loss of a close relative during pregnancy or in the 12 months before conception.
  
  
  
  Population-based cohort study.
  
  
  
  Not applicable.
  
  
  
  All males born in Denmark between 1973 and 2008 (n = 1,217,576) and observed for up to 39 years.
  
  
  
  None.
  
  
  
  Male reproductive function, defined using a composite outcome including congenital malformations of genital organs, testicular cancer, diagnosis of male infertility, or assisted conception use due to male factor infertility.
  
  
  
  In total, 28,986 men (2.4%) had been exposed to prenatal stress, and 62,929 (5.2%) experienced the composite outcome during the follow-up period. Prenatal exposure to stress was associated with an elevated risk of reproductive problems (hazard ratio [HR] 1.09; 95% CI, 1.04-1.15). The association was stronger when the exposure occurred during the first trimester of pregnancy, and for congenital malformations of genital organs. When focusing on infertility alone, we saw no evidence of increased risk (HR 0.90; 95% CI, 0.77-1.06). In addition, the probability of marrying a woman was lower for exposed men (HR 0.93; 95% CI, 0.89-0.98).
  
  
  
  Prenatal stress in the form of the mother's bereavement during the first trimester of pregnancy is associated with a higher risk of reproductive disorders from congenital malformations of the genital organs in the male offspring. The lack of an association between maternal bereavement and later infertility in the exposed male offspring may be due in part to the men's lower probability of attempting to have children.
authors.affiliation: Section of Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark. Electronic address: opr@ph.au.dk.
authors.forename: Oleguer
authors.initials: O
authors.lastname: Plana-Ripoll
authors.affiliation: Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Jiong
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Obstetrics and Gynecology, Herlev and Gentofte Hospital, Herlev, Denmark.
authors.forename: Ulrik Schiøler
authors.initials: US
authors.lastname: Kesmodel
authors.affiliation: Section of Biostatistics, Department of Public Health, Aarhus University, Aarhus, Denmark.
authors.forename: Erik
authors.initials: E
authors.lastname: Parner
authors.affiliation: Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, California.
authors.forename: Jørn
authors.initials: J
authors.lastname: Olsen
authors.affiliation: Department of Obstetrics and Gynecology, Research Institute of the McGill University Health Centre (MUHC), Montreal, Quebec, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada.
authors.forename: Olga
authors.initials: O
authors.lastname: Basso
mesh_terms: D000328:Adult; D032721:Adult Children; D001601:Bereavement; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005298:Fertility; D006801:Humans; D007248:Infertility, Male / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology / Q000628:therapy; D050498:Live Birth; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D011297:Prenatal Exposure Delayed Effects; D060728:Reproductive Health; D027724:Reproductive Techniques, Assisted; D012307:Risk Factors; D012737:Sex Factors; D013315:Stress, Psychological / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D013736:Testicular Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D013997:Time Factors; D014564:Urogenital Abnormalities / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D055815:Young Adult
keywords: Bereavement; cryptorchidism; hypospadias; male infertility; pregnancy; reproductive function; stress