Abstract
In a sample of over one million Swedish first-born offspring, we examined associations between early maternal age at first childbirth (MAFC; i.e., < 20 and 20–24 vs 25–29 years) and offspring non-accidental deaths, accidental deaths, deaths by suicide, non-fatal accidents, and suicide attempts. We included year of birth and several maternal and paternal characteristics as covariates and conducted maternal cousin comparisons to adjust for unmeasured confounding. Early MAFC (e.g., teenage childbearing) was associated with all outcomes, with the most pronounced risk elevation for accidental deaths [Hazard Ratio (HR) < 20 2.50, 95% confidence interval (CI) 2.23, 2.80], suicides (HR < 20 2.08, 95% CI 1.79, 2.41), and suicide attempts (HR < 20 2.85, 95% CI 2.71, 3.00). Adjusting for covariates and comparing cousins greatly attenuated associations (e.g., accidental deaths HR < 20 1.61, 95% CI 1.22, 2.11; suicides HR < 20 1.01, 95% CI 0.69, 1.47; and suicide attempts HR < 20 1.35, 95% CI 1.19, 1.52). A similar pattern emerged for non-accidental deaths and non-fatal accidents. Therefore, results indicated maternal background factors may be largely responsible for observed associations.
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Data Availability
The data used in this study are national register information. The authors had no special privileges in accessing the data. Dissemination of personal information is regulated by the Swedish Secrecy Act. In accordance with Swedish law, researchers seeking access to individual-level data must apply for permission through a Research Ethics Board (etikprovningsmyndigheten.se) and from the primary owners, Statistics Sweden (https://www.scb.se/en/services/guidance-for-researchers-and-universities), and the National Board of Health and Welfare (https://www.socialstyrelsen.se/en/statistics-and-data/statistics/).
Code Availability
We conducted analyses in SAS 9.4 and STATA 16.0.
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Funding
This work was supported by a National Science Foundation Graduate Research Fellowship (1342962 to ACS) and the National Institute of Mental Health of the National Institutes of Health (F31MH121039 to LMO).
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ACS, LMO, and BMD conceptualized and designed the study. ACS analyzed the data. ACS and LMO drafted the manuscript. All authors provided critical revisions. ACS and LMO obtained funding for the study. BMD and ASA provided supervision.
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Ayesha C. Sujan, Lauren M. O’Reilly, Martin E. Rickert, Henrik Larsson, Paul Lichtenstein, A. Sara Oberg and Brian M. D’Onofrio declare that they have no conflict of interest.
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The institutional review board at Indiana University and the regional ethical review board in Stockholm, Sweden, approved this study.
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According to Swedish law, informed consent was not necessary because the study used data available from national Swedish registries.
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All data made available to the investigators were done so without identifying information, and the dataset did not involve “intervention or interaction” with subjects for the proposed research. Analysis of the dataset is exempt under Exemption 45 CFR 46.101(b)(4). It involves the study of “existing data … recorded by the investigator in such a manner that subjects cannot be identified.” These designations have been confirmed with Institutional Review Boards at the IU (#1404771406A003).
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Sujan, A.C., O’Reilly, L.M., Rickert, M.E. et al. A Nation-Wide Swedish Cohort Study on Early Maternal Age at First Childbirth and Risk for Offspring Deaths, Accidents, and Suicide Attempts. Behav Genet 52, 38–47 (2022). https://doi.org/10.1007/s10519-021-10091-7
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DOI: https://doi.org/10.1007/s10519-021-10091-7