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

BJOG. 2016 Feb;123(3):393-8. doi: 10.1111/1471-0528.13268. Epub 2015 Jan 6.


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.

Keywords: Mortality; perinatal loss; stillbirths.

MeSH terms

  • Adult
  • Cause of Death
  • Cohort Studies
  • Follow-Up Studies
  • Humans
  • Infant, Newborn
  • Maternal Mortality*
  • Middle Aged
  • Perinatal Death*