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Increased mortality risk among offspring of mothers with postnatal depression: a nationwide population-based study in Taiwan

Published online by Cambridge University Press:  28 April 2011

Y.-H. Chen ,
S.-Y. Tsai  and
H.-C. Lin
Y.-H. Chen
Affiliation:
School of Public Health, Taipei Medical University, Taipei, Taiwan
S.-Y. Tsai
Affiliation:
Department of Psychiatry, Taipei Medical University Hospital, Taipei, Taiwan
H.-C. Lin*
Affiliation:
School of Health Care Administration, Taipei Medical University, Taipei, Taiwan
*
*Address for correspondence: H.-C. Lin, Ph.D., School of Health Care Administration, Taipei Medical University, 250 Wu-Hsing St, Taipei 110, Taiwan. (Email: henry11111@tmu.edu.tw)
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Abstract

Background

There is compelling evidence that children of mothers with postnatal depression (PD) experience poor developmental outcomes. However, no studies have specifically ascertained the risk of mortality for offspring during preschool years, the most catastrophic outcome in the vulnerable period. This nationwide population-based study aimed to investigate whether maternal depression in the first year after giving birth was associated with increased mortality risk among their preschool children aged up to 5 years.

Method

Three nationwide population-based datasets [the National Health Insurance Research Database (NHIRD), birth certificate registry and death certificate registry] were linked in this study. A total of 10 236 offspring of mothers with PD were recruited, together with a comparison cohort of 81 888 births matched with the affected women in terms of maternal age and year of delivery. Each child was traced for 5 years from delivery between 2001 and 2003 until the end of 2008 to determine mortality during preschool years.

Results

During preschool years, 98 (0.96%) deaths were identified among the offspring of mothers with PD and 470 (0.57%) children in the comparison cohort died. For children up to 5 years old, exposure to maternal PD was independently associated with a 1.47-fold [95% confidence interval (CI) 1.16–1.87] increased mortality risk, after adjusting for family income, urbanization level and the characteristics of mother, father and infant. The risk of death by unnatural causes was even higher (about 2.23 times the risk, 95% CI 1.34–3.70) among exposed offspring.

Conclusions

PD places preschool children at significantly increased risk of mortality, especially from unnatural causes of death.

Keywords

Mortality riskoffspringpostnatal depressionunnatural causes of death
Type
Original Articles
Information
Psychological Medicine , Volume 41 , Issue 11 , November 2011 , pp. 2287 - 2296
Copyright
Copyright © Cambridge University Press 2011

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