All-cause and cause-specific mortality in parents following the death of a child in Taiwan: a population-based cohort study.

OBJECTIVE: Research from Western countries suggests that there is an increase in mortality in parents bereaved by the death of a child. Few studies have investigated this issue in a non-Western context. We explored the impact of the death of a child on parental mortality in Taiwan.

METHOD: By linking population-based national registers, we followed the 2004-2014 birth cohort (N = 2,083,972) up until 2016. A total of 11,755 child deaths were identified. For each deceased child, 4 living children matched on age and sex were randomly selected; their parents were the comparison group. We used Cox proportional hazards regression models to compare the mortality risk of bereaved parents with the comparison group up until 2017.

RESULTS: Overall mortality risk was increased in parents who experienced the death of a child; the risk was higher in bereaved mothers, relative (adjusted Hazard ratio [aHR] = 4.91, 95% Confidence Interval [CI] = [3.96, 6.09]) than fathers: aHR [95%CI] =1.82 [1.55, 2.13]). The risk did not differ according to the sex of the child, but parents whose children died from unexpected causes (i.e. suicide/accidents/violence) were at greater risk than those dying from other causes. Risk was higher when the child was aged >1 year at the time of death than for deaths before age 1-year.

CONCLUSIONS: Parents who lost a child were at increased mortality risk in this East-Asian population. Special attention should be paid to the health of bereaved parents and explore the pathways leading to their risk.