Mortality in mothers after perinatal loss: a population‐based follow‐up study

Objective To assess whether mothers who lost a child from stillbirth or in the first week of life have an increased overall mortality and cause‐specific mortality. Design A population based follow‐up study. Setting Data from Danish national registers. Population All mothers in Denmark were included in the cohort at time of their first delivery from 1 January 1980 to 31 December 2008 and followed until 31 December 2009 or death, whichever came first. Methods The association between perinatal loss and total and cause‐specific mortality in mothers was estimated with hazard ratios (HR) and 95% confidence intervals (95% CI) calculated using Cox proportional hazards regression analyses. Main outcome measures Overall mortality and cause‐specific mortality. Results During the follow‐up period, 838 331 mothers in the cohort gave birth to one or more children and 7690 mothers (0.92%) experienced a perinatal loss. During follow‐up, 8883 mothers (1.06%) died. There was an increased overall mortality for mothers who experienced a perinatal loss adjusted for maternal age and educational level, hazard ratio (HR) 1.83 [95% confidence interval (CI) 1.55–2.17]. The strongest association was seen in mortality from cardiovascular diseases (CVD) with an HR of 2.29 (95% CI 1.48–3.52) adjusted for CVD at time of delivery. We found no association between a perinatal loss and mortality from traumatic causes. Conclusions Mothers who experience a perinatal loss have an increased mortality, especially from CVD.