Offspring psychopathology following preconception, prenatal and postnatal maternal bereavement stress

Abstract

Background Preconception, prenatal, and postnatal maternal stress are associated with increased offspring psychopathology, but findings are inconsistent and need replication. We estimated associations between maternal bereavement stress and offspring autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), bipolar disorder, schizophrenia, suicide attempt, and completed suicide. Methods Using Swedish registers, we conducted the largest population-based study to date examining associations between stress exposure in 738,144 offspring born 1992–2000 for childhood outcomes and 2,155,221 offspring born 1973–1997 for adult outcomes with follow-up through 2009. Maternal stress was defined as death of a first degree relative during 6 months before conception, across pregnancy, or the first two postnatal years. Cox proportional survival analyses were used to obtain hazard ratios (HR) in unadjusted and adjusted analyses. Results Marginal increased risk of bipolar disorder and schizophrenia following preconception bereavement stress was not significant. Third trimester prenatal stress increased risk of ASD (adjusted HR=1.58, 95% CI: 1.15–2.17) and ADHD (adjusted HR=1.31, 95% CI: 1.04–1.66). First postnatal year stress increased risk for offspring suicide attempt (adjusted HR=1.13, 95% CI: 1.02–1.25) and completed suicide (adjusted HR=1.51, 95% CI: 1.08–2.11). Bereavement stress during the second postnatal year increased risk of ASD (adjusted HR=1.30, 95% CI: 1.09–1.55). Conclusions Further research is needed on associations between preconception stress and psychopathological outcomes. Prenatal bereavement stress increases risk of offspring ASD and ADHD. Postnatal bereavement stress moderately increases risk of offspring suicide attempt, completed suicide, and ASD. Smaller previous studies may have overestimated associations between early stress and psychopathological outcomes.

Investigating interactions between early life stress and two single nucleotide polymorphisms in HSD11B2 on the risk of schizophrenia

“…Comparing our current and previous results, we cannot ignore the possibility that analyzing death and serious illness as one exposure might have diluted the effect of exposure to death only in this cohort. However, recent studies from other Scandinavian countries have shown results similar to ours, and they identified no association between the death of a close family member during pregnancy and schizophrenia in the offspring (Abel et al, 2014;Class et al, 2013).…”

“…Early life stress, such as death or serious illness of close relatives, is one such risk factor that has been hypothesized to increase the risk of schizophrenia. However, while some epidemiological studies have found associations between schizophrenia and exposure to early life stress during pregnancy (Huttunen and Niskanen, 1978;Khashan et al, 2008), others have not (Abel et al, 2014;Class et al, 2013). Varying definitions in exposure and outcome result in different estimates, and focused studies aiming to explain potential disease-causing mechanisms are needed.…”

Preconception paternal stress in rats alters dendritic morphology and connectivity in the brain of developing male and female offspring

“…Research has shown that the effect of maternal stress on offspring development has been linked to an increased risk of psychopathologies, including attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), major depressive disorder (MDD), schizophrenia, and drug addiction (Beversdorf et al, 2005;Pelham et al, 2007;Khashan et al, 2008;Bale et al, 2010;Franklin et al, 2010;Arnsten, 2011;Dietz et al, 2011;Kolb et al, 2012;Class et al, 2014). Although there is a well-established relationship between maternal stress and mental health, very little is known regarding the effect of preconception paternal stress (PPS) on the developing brain of offspring.…”

The aetiology of schizophrenia: what have the Swedish Medical Registers taught us?

“…One study investigated the association between prenatal and postnatal bereavement stress; no association was found with schizophrenia; however, associations were found with some other psychiatric morbidities [16].…”