Compared with parents who had not lost a child, mothers were 43 percent more likely to die of any cause within 18 years of a child's death; fathers, 9 percent, the researchers report in the current issue of The Lancet.
The greatest risk of early death for parents came in the three years after a child died, the study found. During that time, mothers were nearly four times as likely to die of unnatural causes, while fathers had a 57 percent greater risk of early, unnatural death.Unnatural deaths consisted mainly of motor vehicle accidents and suicides, and some of the accidents might actually have been hidden suicides or linked to alcohol consumption, depression or grief, says Jorn Olsen, a co-author of the study.
"I think the most significant finding is definitely this high mortality of unnatural causes we see after the death of a child, especially among mothers," says Olsen, an epidemiologist at theEpidemiology Science Centre at University of Aarhus in Denmark. "Losinga child is considered to be one of the most extreme stressors. This typeof life event clearly puts the parents in a high-risk position, especially the mothers and especially shortly after the death of a child."
The study focused on information from Danish death registries from1980 to 1996, tracking about 20,000 parents who lost a child and acontrol group of 293,000 whose children were alive.
The likelihood of a parent's unnatural death declined with the passage of time. However, four to eight years after a child's death, mothers were still nearly twice as likely as those who did not losechildren to die of unnatural causes. And nine to 19 years later, they were 70 percent more likely to face that fate. Fathers were 13 percent more likely to die of unnatural causes nine to 19 years after a child's death.
The death of a child also increased the likelihood of a parent'sdeath from natural causes, including circulatory and digestive diseases,the study found.
Compared with those who had not lost children, bereaved mothers had arisk of death from natural causes 6 percent higher the first three yearsafter the death of a child; 16 percent, the fourth through eighth years;and 44 percent, the ninth through 18th years.
Fathers, by contrast, hada higher death risk from natural causes, 19 percent, only in the nine to19 years after the death of a child.
Olsen suggests mothers may be more likely to die early after losing achild because they're more attached to children than fathers.
Among the study's other findings:
- For mothers, the risks of unnatural death were highest after thedeath of a child aged 3 to 9 and lowest for those less than a month old.
- The likelihood of parents dying early after losing a child decreasedwhen they had more than one child.
- Long-term effects of stress after a child's death can affect the nervous and immune systems, among other things. That can make parents more susceptible toinfectious diseases and increase the risk of cardiovascular disease.
- Stress also can lead to lifestyle changes such as smoking anddrinking alcohol, altering the diet or reducing physical activity -- allof which could increase risk of both natural and unnatural deaths.
Barbara J. Paul, a Philadelphia psychologist who specializes in griefcounseling, says the study shows the devastating impact of the loss of achild.
"It does have a catastrophic impact on the family," Paul says. "Thehealth-care profession, as well as the mental health profession, need tobe aware of that."
Early intervention to improve physical and mental health of grievingparents is crucial, Paul says, and often, increasing physical ailmentsstart to show up nine to 18 months after the death of a child.
However, both parents are often so grief-stricken that they can'thelp each other and thus need support from friends and others, she adds.
Paul says the loss of a child can be more difficult for mothers: "They will often talk about the death of a child as the death of a part of themselves. They feel a part of themselves has died."
Grieving fathers, by contrast, may be at lower risk of early death because they become more involved in work and keeping the family together and functioning, Paul says.