Risk of Cancer among the Offspring of Women Who Experienced Parental Death during Pregnancy

Bermejo, Justo Lorenzo; Sundquist, Jan; Hemminki, Kari

doi:10.1158/1055-9965.epi-07-0638

Cited by 15 publications

(17 citation statements)

References 19 publications

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“…So far, studies on fetal origins of childhood cancer have mostly focused on the associations between leukaemia and certain environmental exposures (Linet et al , 2003; Little, 2009). We observed an increased risk of leukaemia (albeit not statistical significant) and non-Hodgkin's lymphoma as also shown in another study (Bermejo et al , 2007). Our findings also support a role of prenatal stress for testicular cancer (Bermejo et al , 2007), consistent with observations on cryptorchidism (Schottenfeld et al , 1980), indicating a role of intrauterine hormonal disturbances (Garner et al , 2005).…”

Section: Discussionsupporting

confidence: 91%

“…This was not unexpected because specific cancers have different aetiologies and it is unlikely that all cancers are affected by stress-induced changes (Anderson et al , 2000; Reiche et al , 2004; Ekbom, 2006). An earlier study indicated that parental death during pregnancy has been associated with an increased risk of several childhood cancers in the offspring (Bermejo et al , 2007), but these findings were based on fewer cases and the comparison group was the general population of children. We observed that the increased cancer risk in offspring was mainly restricted to maternal bereavement by the death of a child/spouse, which is consistent with our prior hypothesis regarding severity of stress (Skodol and Shrout, 1989).…”

Section: Discussionmentioning

confidence: 99%

“…Experimental research has suggested that its effects on endocrine or immune function may also increase the susceptibility to cancer (Reiche et al , 2004; Ekbom, 2006). It remains, however, unknown whether antenatal stress can lead to childhood cancer in humans (Bermejo et al , 2007). …”

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confidence: 99%

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Antenatal maternal bereavement and childhood cancer in the offspring: a population-based cohort study in 6 million children

Vestergaard

Obel

et al. 2012

Br J Cancer

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Background:Prenatal stress may increase the susceptibility to childhood cancer by affecting immune responses and hormonal balance. We examined whether antenatal stress following maternal bereavement increased the risk of childhood cancer.Methods:All children born in Denmark from 1968 to 2007 (N=2 743 560) and in Sweden from 1973 to 2006 (N=3 400 212) were included in this study. We compared cancer risks in children born to women who lost a first-degree relative (a child, spouse, a parent, or a sibling) the year before pregnancy or during pregnancy with cancer risks in children of women who did not experience such bereavement.Results:A total of 9795 childhood cancer cases were observed during follow-up of 68 360 707 person years. Children born to women who lost a child or a spouse, but not those who lost other relatives, had an average 30% increased risk of any cancer (hazard ratio (HR) 1.30, 95% confidence interval (CI) 0.96–1.77). The HRs were the highest for non-Hodgkin disease (512 cases in total, HR 3.40, 95% CI 1.51–7.65), hepatic cancer (125 cases in total, HR 5.51, 95% CI 1.34–22.64), and testicular cancer (86 cases in total, HR 8.52, 95% CI 2.03–37.73).Conclusion:Our data suggest that severe antenatal stress following maternal bereavement, especially due to loss of a child or a spouse, is associated with an increased risk of certain childhood cancers in the offspring, such as hepatic cancer and non-Hodgkin disease, but not with childhood cancer in general.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

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Antenatal maternal bereavement and childhood cancer in the offspring: a population-based cohort study in 6 million children

Vestergaard

Obel

et al. 2012

Br J Cancer

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“…There is evidence from previous epidemiological studies that bereavement by the death of a close relative has an impact on health and mortality in widowed populations and in bereaved parents [40]–[42]. With regards to prenatal stress due to bereavement for the death of a close relative, it has been indicated that children born to mothers who lost a relative during pregnancy have an increased risk of some types of cancer [43], Type-2 Diabetes [44], childhood overweight [45], attention-deficit/hyperactivity disorder [46] and oral cleft [47].…”

Section: Discussionmentioning

confidence: 99%

Prenatal Exposure to Maternal Bereavement and Childbirths in the Offspring: A Population-Based Cohort Study

et al. 2014

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IntroductionThe decline in birth rates is a concern in public health. Fertility is partly determined before birth by the intrauterine environment and prenatal exposure to maternal stress could, through hormonal disturbance, play a role. There has been such evidence from animal studies but not from humans. We aimed to examine the association between prenatal stress due to maternal bereavement following the death of a relative and childbirths in the offspring.Materials and MethodsThis population-based cohort study included all subjects born in Denmark after 1968 and in Sweden after 1973 and follow-up started at the age of 12 years. Subjects were categorized as exposed if their mothers lost a close relative during pregnancy or the year before and unexposed otherwise. The main outcomes were age at first child and age-specific mean numbers of childbirths. Data was analyzed using Cox Proportional Hazards models stratified by gender and adjusted for several covariates. Subanalyses were performed considering the type of relative deceased and timing of bereavement.ResultsA total of 4,121,596 subjects were followed-up until up to 41 years of age. Of these subjects, 93,635 (2.3%) were exposed and 981,989 (23.8%) had at least one child during follow-up time. Compared to unexposed, the hazard ratio (HR) [95% confidence interval] of having at least one child for exposed males and females were 0.98 [0.96–1.01] and 1.01 [0.98–1.03], respectively. We found a slightly reduced probability of having children in females born to mothers who lost a parent with HR = 0.97 [0.94–0.99] and increased probability in females born to mothers who lost another child (HR = 1.09 [1.04–1.14]), the spouse (HR = 1.29 [1.12–1.48]) or a sibling (HR = 1.13 [1.01–1.27]).ConclusionsOur results suggested no overall association between prenatal exposure to maternal stress and having a child in early adulthood but a longer time of follow-up is necessary in order to reach a firmer conclusion.

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“…Extremely negative influence of prenatal psychological stress and depression on mother-child symbiosis has been established up to an arrest of development of fetus and poor birth outcomes (Newport et al, 2002;Coussons-Read et al, 2006). Death of one parent during pregnancy is connected with high risk of development in the born children four tumor types: childhood acute lymphoblastic leukemia, Hodgkin's disease, embryonic carcinoma of the testis, and appendiceal carcinoid tumors (Bermejo et al, 2007). Family psychological stress is associated with infringement of children immune system functioning and increase in frequency of their disease (Wyman et al, 2007).…”

Section: Population Datamentioning

confidence: 99%

Psychogenic Carcinogenesis

Oleg¹,

Denis²

2012

Advances in Cancer Management

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Risk of Cancer among the Offspring of Women Who Experienced Parental Death during Pregnancy

Cited by 15 publications

References 19 publications

Antenatal maternal bereavement and childhood cancer in the offspring: a population-based cohort study in 6 million children

Antenatal maternal bereavement and childhood cancer in the offspring: a population-based cohort study in 6 million children

Prenatal Exposure to Maternal Bereavement and Childbirths in the Offspring: A Population-Based Cohort Study

Psychogenic Carcinogenesis

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