Parental morbidity and mortality following the birth of a child with major congenital anomalies: A population-based cohort study

BACKGROUND/PURPOSE: Caregiving has both positive and negative effects, but its health impact on parents of children with major congenital anomalies remains unclear, particularly outside Western contexts. Most research focuses on maternal outcomes and suggests adverse health consequences. This study explores whether parents of children with major congenital anomalies in Taiwan face an increased risk of morbidity and mortality. METHODS: We conducted a population-based retrospective cohort study using the 2004-2015 birth cohort (N = 2,294,292). Parents of children with major congenital anomalies (mothers: N = 92,656; fathers: N = 88,224) were matched 1:4 with parents of unaffected children based on age, birth year, and parity. The cohort was followed up until 2017. Cox proportional hazards models were applied to compare morbidity and all-cause mortality over 14 years of follow-up. RESULTS: Mothers of children with major congenital anomalies had a higher risk of multiple admissions (adjusted Hazard Ratio [aHR] = 1.23, 95% Confidence Interval [CI] = 1.18-1.27). Mortality risk for exposed mothers did not increase substantially. The risk of multiple admissions in exposed fathers rose only after 7 years of follow-up (aHR = 1.11, 95% CI = 1.05-1.17). Exposed fathers had lower mortality risk compared to unexposed fathers (aHR = 0.82, 95% CI = 0.76-0.89). CONCLUSIONS: This study identified increased morbidity among parents of children with major congenital anomalies, although mortality did not increase. Fathers exhibited a lower mortality risk, possibly indicating that caregiving, while demanding, may also offer protective benefits. Further research is needed to explore this effect and inform targeted interventions to support parental well-being.