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Maternal psychiatric and somatic illness, and the risk of unintentional injuries in children: variation by type of maternal illness, type of injury and child age
  1. Antti O Tanskanen1,2,
  2. Niina Metsä-Simola3,
  3. Lotta Volotinen3,
  4. Mirkka Danielsbacka1,2,
  5. Pekka Martikainen3,4,5,
  6. Hanna Remes3
  1. 1 Population Research Institute, Väestöliitto, Helsinki, Finland
  2. 2 INVEST Research Center, University of Turku, Turku, Finland
  3. 3 Population Research Unit, University of Helsinki, Helsinki, Finland
  4. 4 Max Planck - Institute for Demographic Research, Rostock, Germany
  5. 5 Max Planck - University of Helsinki Center for Social Inequalities in Population Health, University of Helsinki, Helsinki, Finland
  1. Correspondence to Antti O Tanskanen, Population Research Institute, Väestöliitto, Helsinki, Finland; antti.tanskanen{at}utu.fi

Abstract

Background Maternal mental illness appears to increase the risk of unintentional childhood injuries, which are a common cause of morbidity and mortality in early childhood. However, little is known about the variations in this association by type of injury and child’s age, and studies on the effects of maternal somatic illness on children’s injury risk are scarce.

Methods We used Finnish total population register data from 2000 to 2017 to link 1 369 325 children to their biological mothers and followed them for maternal illness and childhood injuries until the children’s sixth birthday. Cox regression models were used to examine the associations between maternal illness and children’s injuries by type of illness (neurological, psychiatric and cancer), type of injury (transport injuries, falls, burns, drowning or suffocations, poisonings, exposure to inanimate and animate mechanical forces) and child’s age (<1 year-olds, 1–2 year-olds, 3–5 year-olds).

Results After adjustment for family structure, maternal age at birth, maternal education, income, child’s gender, native language and region of residence, children of unwell mothers showed a higher risk of injuries (HR: 1.21, 95% CI: 1.19 to 1.23). This association was clear for maternal neurological (HR: 1.31, 95% CI: 1.26 to 1.36) and psychiatric illnesses (HR: 1.20, 95% CI: 1.18 to 1.23) but inconsistent for cancer. Maternal illness predicted an increased risk of injury across all age groups.

Conclusions Maternal mental and somatic illness may both increase children’s injury risk. Adequate social and parenting support for families with maternal illness may reduce childhood injury.

  • accidents
  • maternal health
  • longitudinal studies

Data availability statement

Data may be obtained from a third party and are not publicly available. The data used in this study were collected by register authorities and are not publicly available. Those interested may apply for permission to use these data for scientific research from the register holders Statistics Finland, the Finnish Institute of Health and Welfare and the Social Insurance Institution. Data from Statistics Finland: tutkijapalvelut@tilastokeskus.fi. Data from the Finnish Institute of Health and Welfare and the Social Insurance Institution: info@findata.fi.

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Data availability statement

Data may be obtained from a third party and are not publicly available. The data used in this study were collected by register authorities and are not publicly available. Those interested may apply for permission to use these data for scientific research from the register holders Statistics Finland, the Finnish Institute of Health and Welfare and the Social Insurance Institution. Data from Statistics Finland: tutkijapalvelut@tilastokeskus.fi. Data from the Finnish Institute of Health and Welfare and the Social Insurance Institution: info@findata.fi.

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Footnotes

  • Twitter @LottaVol

  • Contributors AOT had the original idea. AOT, NM-S and HR conceived and designed the study. LV conducted the data analyses with the help from NM-S and HR. AOT wrote the first draft of the paper and NM-S and HR made critical revisions. All authors contributed to the writing of the paper and interpretation of the results. All authors approved the final draft of the manuscript. AOT, NM-S and HR are guarantors of the study.

  • Funding The study was supported by the Strategic Research Council through the Academy of Finland grants for ACElife (352543-352572), LIFECON (308247) and NetResilience (345183), the European Research Council under the European Union’s Horizon 2020 research and innovation program (grant agreement No 101019329), Academy of Finland (338869, 331400, 320162, 325857), and grants to the Max Planck - University of Helsinki Center from the Jane and Aatos Erkko Foundation, the Max Planck Society, University of Helsinki, and Cities of Helsinki, Vantaa and Espoo.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.