Parental mental illness, attendance at preventive child healthcare and dental caries in the offspring: a nation-wide pop
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ORIGINAL PAPER
Parental mental illness, attendance at preventive child healthcare and dental caries in the offspring: a nation‑wide population‑based cohort study Kirstine A. Davidsen1,2 · Erik Christiansen2 · Dorte Haubek3 · Jette Asmussen2,4 · Anne Ranning5 · Anne A. E. Thorup5,6 · Merete Nordentoft5 · Susanne Harder7 · Niels Bilenberg2,4 Received: 5 March 2020 / Accepted: 7 August 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Severe mental illness (SMI) may interfere with parental caregiving practices and offspring development. Adhering to preventive well-child visits and maintaining good oral hygiene during early childhood requires parental involvement. Whether these activities are affected by parental SMI is unclear. The purpose of the present study was to determine whether children exposed to parental SMI are at increased risk of non-attendance to preventive well-child visits and vaccinations at age 0–5 years and of child dental caries experience at age 5 years. Furthermore, interactions between maternal psychiatric and sociodemographic variables in relation to an adverse child outcome were assessed. Methods Data were obtained from national Danish health registers. All children born in Denmark between January 1997 and December 2010 were followed from birth until their 6th birthday. Results 679,339 children were included in the study (51% male). Of these, 49,059 children (7.8%) had at least one parent with a lifetime SMI diagnosis. Children of parents with SMI had elevated odds of missing well-child visits and vaccinations (OR 1.41; 95% CI 1.39–1.44, p 1 year after child birth). The latter was chosen as a proxy for disease activity in order to illuminate whether disease activity around childbirth or during the child’s upbringing affects compliance with preventive child healthcare. Furthermore, socioeconomic classification (high/low) and child living only with mother (Y/N) were included to illuminate the role of additional contextual risk factors of exposed children.
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Results A total of 883,380 children were identified. 204,041 individuals were excluded because of missing on outcome and 679,339 children were included and followed from birth up to and including 5 years of age. In comparison to included individuals, mothers of excluded individuals were more likely to have low SES, be younger or older, be immigrant or descendant, have schizophrenia or depression and have contact to a mental hospital within one year after birth. Fathers of excluded individuals were more likely to be younger or older, be immigrant or descendant and have depression. The excluded children were more likely to be male, not be first born and living with only one parent. All these findings are significant on a 5% level. Of the included individuals, 49,059 children (7.8%) had at least one parent with a lifetime diagnosis of SMI, 2159 had both parents with SMI. Parents with SMI were generally younger at the child’s birth and more often immigrants than parents without SMI. Materna
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