ABSTRACT
PURPOSE: Higher maternal parity and younger maternal age have each been observed to be associated with subsequent offspring suicidal behaviour. This study aimed to establish if these, and other variables from the perinatal period, together with family size, are also associated with other psychiatric morbidity. METHODS: Linked datasets of the Scottish Morbidity Record and Scottish death records were used to follow up, into young adulthood, a birth cohort of 897,685. In addition to the index maternity records, mothers' subsequent pregnancy records were identified, allowing family size to be estimated. Three independent outcomes were studied: suicide, self-harm, and psychiatric hospital admission. Data were analysed using Cox regression. RESULTS: Younger maternal age and higher maternal parity were independently associated with increased risk in offspring of suicide, of self-harm and of psychiatric admission. Risk of psychiatric admission was higher amongst those from families of three or more, but, compared with only children, those with two or three siblings had a lower risk of self harm. CONCLUSION: Perinatal and family composition factors have a broad influence on mental health outcomes. These data suggest that the existence of younger, as well as elder siblings may be important.
Subject(s)
Family Characteristics , Parity , Perinatal Mortality/trends , Prenatal Exposure Delayed Effects/epidemiology , Suicidal Ideation , Suicide, Attempted/statistics & numerical data , Adolescent , Adult , Age Factors , Birth Certificates , Birth Weight , Cohort Studies , Data Collection , Female , Gestational Age , Hospitals, Psychiatric , Humans , Male , Maternal Age , Middle Aged , Patient Discharge/statistics & numerical data , Patient Discharge/trends , Poverty/statistics & numerical data , Pregnancy , Proportional Hazards Models , Risk Factors , Scotland/epidemiology , Sex Distribution , Vulnerable Populations/statistics & numerical dataABSTRACT
Pregnancy complications and cardiovascular disease share some common determinants. It has previously been hypothesized that family history of cardiovascular disease would be associated with low birth weight. Records from 120,317 Scottish births, 1992-2006, were linked to hospital admission and death certificate data for 71,681 pairs of maternal grandparents. There was a negative relation between the birth weight of the baby and the risk of either grandparent's experiencing ischemic heart disease (for a 1-kg increase in birth weight, hazard ratio = 0.86, 95% confidence interval: 0.83, 0.89) or cerebrovascular disease (hazard ratio = 0.82, 95% confidence interval: 0.77, 0.87). Further analysis demonstrated that the associations were explained by increased risks of both delivering a small-for-gestational-age infant and delivering preterm among women whose parents had experienced cardiovascular disease. Adjustment for the mother's characteristics at the time of the birth attenuated the relation, but significant associations persisted: With a 1-kg increase in birth weight, the adjusted hazard ratio for ischemic heart disease = 0.93 (95% confidence interval: 0.89, 0.96) and for cerebrovascular disease = 0.93 (95% confidence interval: 0.89, 0.96). Familial aggregation of common determinants of pregnancy complications and cardiovascular disease is the likely explanation for the relation between an infant's birth weight and the risk of cardiovascular disease in other family members.
