Mental Health in Adulthood after Prenatal Exposure to Maternal Stress Due to Sudden Loss of Close Relatives.

Yael Broos , Erasmus School of Health Policy & Management
Thijs van den Broek, Erasmus School of Health Policy and Management
Anna Nieboer, Erasmus School of Health Policy and Management

Background Losses of close relatives have a well-documented impact on the mental health of those left behind. Maternal losses during pregnancy have similarly been linked to poorer mental health in offspring, yet causal evidence on in-utero effects remains limited. Our study accounts for socioeconomic differences that influence both exposure to maternal loss and offspring mental health outcomes, providing new causal evidence on the long-term effects of maternal loss during pregnancy. Methods We exploit the random timing of sudden maternal losses of close relatives within a time frame around births as an exogenous source of maternal stress to estimate its impact on offsprings’ later-life mental health. Using Norwegian population registers covering births from 1960-2003, we estimate linear probability models using pooled ordinary least squares, to compare mental health care use of children exposed to maternal loss in utero (treatment group) to those exposed shortly after birth (control group). Results Offspring exposed in utero has an raised probability of using mental health care in later life of 1.08 percentage point, compared to those exposed post birth. We observed adverse mental health outcomes in those exposed in utero if the maternal loss occurred in the first (1.69 percentage point) or last trimester (1.80 percentage point), but not in the second trimester. Conclusion Our findings highlight that maternal distress during pregnancy has long-term implications for offspring mental health. Increased attention for maternal mental health concerns is therefore crucial to prevent effects from spanning generations and to help reduce health disparities associated with social inequalities.

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 Presented in Session 93. Social Inequalities in Morbidity and Disparities in Mental Health