Loss of a child and the risk of atrial fibrillation: a Danish population-based prospective cohort study.

ABSTRACT

BACKGROUND: Several studies suggest that bereavement is associated with increased risks of ischaemic heart disease, heart failure, stroke and cardiovascular mortality. Knowledge regarding the link between bereavement and the risk of atrial fibrillation (AF) is limited. We investigated whether the death of a child, one of the most severe forms of bereavement, is associated with AF. METHODS: We conducted a population-based cohort study involving parents of live-born children during 1973-2016 from the Danish Medical Birth Register (n=2 804 244). Information on children's death, parental AF and sociodemographic and other health-related characteristics was obtained by individual-level linkage between several Danish population-based registers. We analysed the association between loss of a child and AF using Poisson regression. RESULTS: During the up to 39 years follow-up, 64 216 (2.3%) parents lost a child and 74 705 (2.7%) had an AF. Bereaved parents had a higher risk of AF than the non-bereaved; the corresponding incidence rate ratio (IRR) and 95% CI were 1.12 (1.08 to 1.17). The association was present both when the child died of cardiovascular diseases (IRR (95% CI) 1.42 (1.20 to 1.69)), and of other causes (IRR (95% CI) 1.11 (1.06 to 1.16)), tended to be U-shaped according to the deceased child's age at loss, but did not differ substantially according to the number of remaining live children at loss, the number of deceased children or the time since the loss. CONCLUSIONS: The death of a child was associated with a modestly increased risk of AF. Bereaved parents may benefit from increased support from family members and health professionals.