European Child & Adolescent Psychiatry

, Volume 19, Issue 10, pp 747–753 | Cite as

Attention-deficit/hyperactivity disorder in the offspring following prenatal maternal bereavement: a nationwide follow-up study in Denmark

  • Jiong Li
  • Jørn Olsen
  • Mogens Vestergaard
  • Carsten Obel
Original Contribution


Severe prenatal stress exposure has been found to increase the risk of neuropsychiatric conditions like schizophrenia. We examined the risk of attention-deficit/hyperactivity disorder (ADHD) in the offspring following prenatal maternal bereavement, as a potential source of stress exposure. We conducted a nationwide population-based cohort study including all 1,015,912 singletons born in Denmark from 1987 to 2001. A total of 29,094 children were born to women who lost a close relative during pregnancy or up to 1 year before pregnancy. These children were included in the exposed cohort and other children were in the unexposed cohort. We used Cox regression to estimate hazard ratios for ADHD, defined as the first-time ADHD hospitalization or first-time ADHD medication after 3 years of age. Boys born to mothers who were bereaved by unexpected death of a child or a spouse, had a 72% increased risk of ADHD [hazard ratio (HR) 1.72, 95% confidence interval (CI) 1.09–2.73]. Boys born to mothers who lost a child or a spouse during 0–6 months before pregnancy and during pregnancy had a HR of 1.47 (95% CI 1.00–2.16) and 2.10 (95% CI 1.16–3.80), respectively. Our findings suggest that prenatal maternal exposure to severe stress may increase the risk of ADHD in the offspring.


Attention-deficit/hyperactivity disorder (ADHD) Stress Bereavement Fetal programming Child psychiatry 



The study was supported by the Danish Medical Research Council (project no. 271-05-0616, project no. 271-07-0437), Gigtforeningen (R54-A596-B286), Nordic Cancer Union (2008), and NordForsk (070331).

Conflict of interest statement



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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Jiong Li
    • 1
  • Jørn Olsen
    • 1
    • 2
  • Mogens Vestergaard
    • 3
  • Carsten Obel
    • 3
  1. 1.Department of Epidemiology, The Danish Epidemiology Science Centre, Institute of Public HealthThe University of AarhusAarhusDenmark
  2. 2.Department of Epidemiology, School of Public HealthUniversity of CaliforniaLos AngelesUSA
  3. 3.Department of General Practice, Institute of Public HealthUniversity of AarhusAarhusDenmark

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