Maternal Antenatal Bereavement and Neural Tube Defect in Live-Born Offspring: A Cohort Study

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Background

Maternal emotional stress during pregnancy has previously been associated with congenital neural malformations, but most studies are based on data collected retrospectively. The objective of our study was to investigate associations between antenatal maternal bereavement due to death of a close relative and neural tube defects (NTDs) in the offspring.

Methods

We performed a register-based cohort study including all live-born children (N = 1,734,190) from 1978–2008. Exposure was bereavement due to loss of a close relative from one year before conception to the end of the first trimester of pregnancy. The outcome was NTDs in the offspring according to the International Classification of Disease. We used multivariate logistic regression to estimate prevalence odds ratios (ORs).

Results

A total of 2% children were born to mothers who lost a close relative prenatally. During 30 years of follow-up, 1,115 children were diagnosed with any NTDs: spina bifida (n = 889), anencephaly (n = 85) and encephalocele (n = 164). And 23 children were diagnosed with two types of NTDs. Overall, when comparing bereaved mothers to non-bereaved mothers, no significant increased prevalence of NTDs in the offspring was seen (OR = 0.84; 95% confidence interval: 0.52–1.33).

Conclusion

Overall maternal bereavement in the antenatal period was not related to NTDs in liveborn offspring.

Related collections

Most cited references 31

Record: found
Abstract: found
Article: not found

The Danish Civil Registration System. A cohort of eight million persons.

Carsten Bøcker Pedersen, Heine Gøtzsche, Jørgen Ostrup Møller … (2006)

The Danish Civil Registration System (CRS) was established in 1968, where all persons alive and living in Denmark were registered. Among many other variables, it includes individual information on personal identification number, gender, date of birth, place of birth, place of residence, citizenship, continuously updated information on vital status, and the identity of parents and spouses. To evaluate the quality and completeness of the information recorded on persons in the CRS, we considered all persons registered on November 4, 2005, i.e. all persons who were alive and resident in Denmark at least one day from April 2, 1968 to November 4, 2005, or in Greenland from May 1, 1972 to November 4, 2005. A total of 8,176,097 persons were registered. On November 4, 2005, 5,427,687 (66.4%) were alive and resident in Denmark, 56,920 (0.7%) were alive and resident in Greenland, 2,141,373 (26.2%) were dead, 21,160 (0.3%) had disappeared, and 528,957 (6.5%) had emigrated. Among persons born in Denmark 1960 or later the CRS contains complete information on maternal identity. Among persons born in Denmark 1970 or later the CRS contains complete information on paternal identity. Among women born in Denmark April 1935 or later the CRS contains complete information on all their children. Among males born in Denmark April 1945 or later the CRS contains complete information on all their children. The CRS contains complete information on: a) immigrations and emigrations from 1971 onwards, b) permanent residence in a Danish municipality from 1971 onwards, c) permanent residence in a municipality in Greenland from May 1972 onwards, and d) full address in Denmark from 1977 onwards. Data from the CRS is an important research tool in epidemiological research, which enables Danish researchers to carry out representative population-based studies on e.g. the potential clustering of disease and death in families and the potential association between residence and disease and death.

0 comments Cited 364 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

The Danish National Birth Cohort--its background, structure and aim.

J. Olsen, M Melbye, S. F. Olsen … (2001)

It is well known that the time from conception to early childhood has importance for health conditions that reach into later stages of life. Recent research supports this view, and diseases such as cardiovascular morbidity, cancer, mental illnesses, asthma, and allergy may all have component causes that act early in life. Exposures in this period, which influence fetal growth, cell divisions, and organ functioning, may have long-lasting impact on health and disease susceptibility. To investigate these issues the Danish National Birth Cohort (Better health for mother and child) was established. A large cohort of pregnant women with long-term follow-up of the offspring was the obvious choice because many of the exposures of interest cannot be reconstructed with sufficient validity back in time. The study needs to be large, and it is aimed to recruit 100,000 women early in pregnancy, and to continue follow-up for decades. The Nordic countries are better suited for this kind of research than most other countries because of their population-based registers on diseases, demography and social conditions, linkable at the individual level by means of the unique ID-number given to all citizens. Exposure information is mainly collected by computer-assisted telephone interviews with the women twice during pregnancy and when their children are six and 18 months old. Participants are also asked to fill in a self-administered food frequency questionnaire in mid-pregnancy. Furthermore, a biological bank has been set up with blood taken from the mother twice during pregnancy and blood from the umbilical cord taken shortly after birth. Data collection started in 1996 and the project covered all regions in Denmark in 1999. By August 2000. a total of 60,000 pregnant women had been recruited to the study. It is expected that a large number of gene-environmental hypotheses need to be based on case-control analyses within a cohort like this.

0 comments Cited 254 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Prevention of neural tube defects: results of the Medical Research Council Vitamin Study. MRC Vitamin Study Research Group.

J. F. Sneddon, J Densem, N Wald … (1991)

A randomised double-blind prevention trial with a factorial design was conducted at 33 centres in seven countries to determine whether supplementation with folic acid (one of the vitamins in the B group) or a mixture of seven other vitamins (A,D,B1,B2,B6,C and nicotinamide) around the time of conception can prevent neural tube defects (anencephaly, spina bifida, encephalocele). A total of 1817 women at high risk of having a pregnancy with a neural tube defect, because of a previous affected pregnancy, were allocated at random to one of four groups--namely, folic acid, other vitamins, both, or neither. 1195 had a completed pregnancy in which the fetus or infant was known to have or not have a neural tube defect; 27 of these had a known neural tube defect, 6 in the folic acid groups and 21 in the two other groups, a 72% protective effect (relative risk 0.28, 95% confidence interval 0.12-0.71). The other vitamins showed no significant protective effect (relative risk 0.80, 95% Cl 0.32-1.72). There was no demonstrable harm from the folic acid supplementation, though the ability of the study to detect rare or slight adverse effects was limited. Folic acid supplementation starting before pregnancy can now be firmly recommended for all women who have had an affected pregnancy, and public health measures should be taken to ensure that the diet of all women who may bear children contains an adequate amount of folic acid.

0 comments Cited 226 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

Claudia Kappen: Role: Editor

Journal

Journal ID (nlm-ta): PLoS One

Journal ID (iso-abbrev): PLoS ONE

Journal ID (publisher-id): plos

Journal ID (pmc): plosone

Title: PLoS ONE

Publisher: Public Library of Science (San Francisco, CA USA )

ISSN (Electronic): 1932-6203

Publication date (Electronic): 29 September 2016

Publication date Collection: 2016

Volume: 11

Issue: 9

Electronic Location Identifier: e0163355

Affiliations

[1 ]Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus C, Denmark

[2 ]Research Unit for Obstetrics and Gynecology, Institute of Clinical Research, University of Southern Denmark, Odense C, Denmark

[3 ]Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, United States of America

[4 ]Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark

Pennington Biomedical Research Center, UNITED STATES

Author notes

Competing Interests: The authors have declared that no competing interests exist.

Conceived and designed the experiments: KI JO JL.
Contributed reagents/materials/analysis tools: KI CW JO EN BB JL.
Interpretation and revising the manuscript critically: KI CW JO EN BB JL.

* E-mail: ki@ 123456soci.au.dk

Article

Publisher ID: PONE-D-16-27310

DOI: 10.1371/journal.pone.0163355

PMC ID: 5042438

PubMed ID: 27685943

SO-VID: f04cac6d-57f9-4960-b6e2-7a82112cab21

License:

This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

History

Date received : 8 July 2016

Date accepted : 7 September 2016

Page count

Figures: 0, Tables: 2, Pages: 10

Funding

Funded by: funder-id http://dx.doi.org/10.13039/100008392, Sundhed og Sygdom, Det Frie Forskningsråd;

Award Recipient : Jiong Li

The study was supported by several grants: The European Research Council (ERC-2010-StG-260242-PROGEURO), Danish Medical Re- search Council (Project no. 438037), the Nordic Cancer Union (2013_129830, 2015_176673), DFF-6110-00019, and Karen Elise Jensens Fond (2016).

Custom metadata

Data Availability Data are available from Statistic Denmark for researchers who meet the criteria for access to confidential data.

Maternal Antenatal Bereavement and Neural Tube Defect in Live-Born Offspring: A Cohort Study

Read this article at

Abstract

Background

Methods

Results

Conclusion

Related collections

PLOS Climate

Most cited references 31

The Danish Civil Registration System. A cohort of eight million persons.

The Danish National Birth Cohort--its background, structure and aim.

Prevention of neural tube defects: results of the Medical Research Council Vitamin Study. MRC Vitamin Study Research Group.

Author and article information

Contributors

Journal

Affiliations

Author notes

Article

History

Page count

Funding

Categories

Custom metadata

Comments

Comment on this article

Similar content 198

Most referenced authors 828