{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T03:31:00Z","timestamp":1771039860858,"version":"3.50.1"},"reference-count":46,"publisher":"American Academy of Pediatrics (AAP)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,5,1]]},"abstract":"<jats:sec><jats:title\/><\/jats:sec><jats:sec><jats:title>BACKGROUND:<\/jats:title><jats:p>A mother whose child has a chronic condition, such as a major congenital anomaly, often experiences poorer long-term health, including earlier mortality. Little is known about the long-term health of fathers of infants with a major congenital anomaly.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS:<\/jats:title><jats:p>In this population-based prospective cohort study, we used individual-linked Danish registry data. Included were all mothers and fathers with a singleton infant born January 1, 1986, to December 31, 2015. Cox proportional hazards regression was used to generate hazard ratios for all-cause and cause-specific mortality among mothers and fathers whose infant had an anomaly and fathers of unaffected infants, relative to mothers of unaffected infants (referent), adjusted for child\u2019s year of birth, parity, parental age at birth, parental comorbidities, and sociodemographic characteristics.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS:<\/jats:title><jats:p>In total, 20\u2009952 of 965\u2009310 mothers (2.2%) and 20\u2009655 of 951\u2009022 fathers (2.2%) had an infant with a major anomaly. Median (interquartile range) of parental follow-up was 17.9 (9.5 to 25.5) years. Relative to mothers of unaffected infants, mothers of affected infants had adjusted hazard ratios (aHRs) of death of 1.20 (95% confidence interval [CI]: 1.09 to 1.32), fathers of unaffected infants had intermediate aHR (1.62, 95% CI: 1.59 to 1.66), and fathers of affected infants had the highest aHR (1.76, 95% CI: 1.64 to 1.88). Heightened mortality was primarily due to cardiovascular and endocrine\/metabolic diseases.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS:<\/jats:title><jats:p>Mothers and fathers of infants with a major congenital anomaly experience an increased risk of mortality, often from preventable causes. These findings support including fathers in interventions to support the health of parental caregivers.<\/jats:p><\/jats:sec>","DOI":"10.1542\/peds.2020-028571","type":"journal-article","created":{"date-parts":[[2021,4,2]],"date-time":"2021-04-02T08:25:19Z","timestamp":1617351919000},"source":"Crossref","is-referenced-by-count":13,"title":["Mortality Among Parents of Children With Major Congenital Anomalies"],"prefix":"10.1542","volume":"147","author":[{"given":"Anne E.","family":"Fuller","sequence":"first","affiliation":[{"name":"Department of Pediatrics, The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada;"},{"name":"Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada;"},{"name":"Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erzs\u00e9bet","family":"Horv\u00e1th-Puh\u00f3","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joel G.","family":"Ray","sequence":"additional","affiliation":[{"name":"Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada;"},{"name":"Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada;"},{"name":"Department of Medicine, St Michael\u2019s Hospital and University of Toronto, Toronto, Ontario, Canada; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vera","family":"Ehrenstein","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henrik Toft","family":"S\u00f8rensen","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark;"},{"name":"Centre for Population Health Sciences, Stanford University, Stanford, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eyal","family":"Cohen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada;"},{"name":"Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2021,5,1]]},"reference":[{"issue":"12","key":"2021121008103711200_B1","doi-asserted-by":"crossref","first-page":"1008","DOI":"10.1002\/bdra.20735","article-title":"Updated National Birth Prevalence estimates for selected birth defects in the United States, 2004-2006","volume":"88","author":"Parker","year":"2010","journal-title":"Birth Defects Res A Clin Mol Teratol"},{"issue":"6","key":"2021121008103711200_B2","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1111\/jir.12692","article-title":"Psychological well-being of fathers with and without a child with intellectual disability: a population-based study","volume":"64","author":"Langley","year":"2020","journal-title":"J Intellect Disabil Res"},{"key":"2021121008103711200_B3","volume-title":"March of Dimes Global Report on Birth Defects: The Hidden Toll of Dying and Disabled Children","author":"Christianson","year":"2006"},{"issue":"3","key":"2021121008103711200_B4","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1080\/01460860290042558","article-title":"Stress in families with medically fragile children","volume":"25","author":"Ratliffe","year":"2002","journal-title":"Issues Compr Pediatr Nurs"},{"issue":"2","key":"2021121008103711200_B5","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1007\/s10995-005-4870-x","article-title":"Financial burden for families of children with special health care needs","volume":"9","author":"Kuhlthau","year":"2005","journal-title":"Matern Child Health J"},{"issue":"6","key":"2021121008103711200_B6","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2004-1689","article-title":"The health and well-being of caregivers of children with cerebral palsy","volume":"115","author":"Raina","year":"2005","journal-title":"Pediatrics"},{"issue":"23","key":"2021121008103711200_B7","doi-asserted-by":"crossref","first-page":"2515","DOI":"10.1001\/jama.2016.18425","article-title":"Association between the birth of an infant with major congenital anomalies and subsequent risk of mortality in their mothers","volume":"316","author":"Cohen","year":"2016","journal-title":"JAMA"},{"issue":"5","key":"2021121008103711200_B8","doi-asserted-by":"crossref","first-page":"e182320","DOI":"10.1001\/jamanetworkopen.2018.2320","article-title":"Cardiovascular disease among women who gave birth to an infant with a major congenital anomaly. 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