Maternal stress, anxiety pose increased future risk of fracture in offspring

The presence of maternal stress or anxiety disorders prior to or following childbirth may be detrimental to children, bearing an increased hazard of fractures in early life, as shown in a recent study.

In a cohort of 773,339 newborns born in Quebec, Canada, between 2006 and 2018, 8,249 infants (1.1 percent) were hospitalized for fractures during 5,331,205 person-years of follow-up. This corresponded to an overall incidence rate of 15.5 (95 percent confidence interval [CI], 15.2–15.7) per 10,000 person-years.

Notably, fracture incidence was greater among children born to mothers with stress or anxiety disorders, or both, vs those born to mothers without the said disorders (20.5, 19.8 and 21.9 vs 15.3 per 10,000 person-years, respectively).

In fully adjusted Cox proportional hazards regression models, the risk of paediatric fractures increased by 22 percent in the presence of any stress or anxiety disorders (hazard ratio [HR], 1.22, 95 percent CI, 1.09–1.36) and by 25 percent in the presence of both (HR, 1.25, 95 percent CI, 0.90–1.73) percent.

Maternal stress was predominantly associated with fall-related fractures (HR, 1.26, 95 percent CI, 1.06–1.50) and maternal anxiety with assault-related fractures (HR, 2.97, 95 percent CI, 1.50–5.89). The link of maternal stress and anxiety disorders to fall-related fractures was more pronounced after 36 months of age, whereas the link to assault-related fractures was more evident before 6 months of age.

The findings underscore the importance of providing counsel and social support to women with history of stress or anxiety disorders to prevent fractures in children, researchers said.