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Research article
Parental mental health conditions and use of healthcare services in children the first year of life – a register-based, nationwide study
Signe Heuckendorff
Aalborg Universitetshospital
Corresponding Author
ORCiD: https://orcid.org/0000-0002-4074-064X
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Parental mental health conditions have been associated with increased morbidity and use of healthcare services in offspring. Existing studies have not examined different severities of parental mental health conditions, and the impact of paternal mental health has been overlooked.
We examined the association between two severities of parental mental health conditions and use of healthcare services for children during the first year of life and explored the impact of both maternal and paternal mental health conditions.
Methods
This register-based cohort study included all live-born children born in Denmark from 2000-2016. Information on socioeconomics, diagnoses, drug prescriptions, and healthcare contacts was extracted from nationwide public registries. Parents were grouped according to severity of mental condition based on the place of treatment of the mental health condition. Negative binominal regression analyses were performed to estimate the incidence rate ratio (IRR) of contacts to general practice (GP), out-of-hour medical service, emergency room (ER), and out- and inpatient hospital contacts during the first 12 months of the child’s life.
Results
The analyses included 964395 children. Twenty percent of the mothers and twelve percent of the fathers were identified with mental health conditions. Paternal mental health conditions were independently associated with increased risk of infant healthcare contacts (GP IRR 1.05 (CI95% 1.04-1.06) and out-of-hour IRR 1.20 (CI95% 1.18-1.22)). Risks were higher for maternal mental health conditions (GP IRR 1.18 (CI95% 1.17-1.19) and out-of-hour IRR 1.39 (CI95% 1.37-1.41)). The risks were even higher if both parents were classified with a mental health condition (GP IRR 1.25 (CI95% 1.23-1.27) and out-of-hour contacts IRR 1.49 (CI95% 1.45-1.54)), including minor mental health condition (GP IRR 1.22 (CI95% 1.21-1.24) and out-of-hour IRR 1.37 (CI95% 1.34-1.41)). This pattern was the same for all types of healthcare contacts.
Conclusions
Both maternal and paternal mental health conditions, including minor mental health conditions, were associated with increased utilization of healthcare services. Focus on both parents’ mental health conditions (even if minor) may be warranted in service planning.
Keywords
Parental mental health, child health, healthcare services, mental health conditions
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CURRENT STATUS: Under Review
Version 3
Posted 31 Dec, 2020
No community comments so far
Reviewer #2 agreed
On 07 Jan, 2021
Review #1 received
Received 03 Jan, 2021
Reviewer #1 agreed
On 16 Dec, 2020
Reviewers invited
Invitations sent on 13 Dec, 2020
Editor assigned
On 12 Dec, 2020
Submission checks complete
On 12 Dec, 2020
Editor invited
On 12 Dec, 2020
No comments provided
Editorial decision: Major revision
On 11 Nov, 2020
Review #2 received
Received 16 Oct, 2020
Review #3 received
Received 15 Oct, 2020
Reviewer #3 agreed
On 15 Oct, 2020
Reviewer #2 agreed
On 15 Oct, 2020
Review #1 received
Received 07 Sep, 2020
Reviewer #1 agreed
On 15 Aug, 2020
Reviewers invited
Invitations sent on 08 Jul, 2020
Editor assigned
On 07 Jun, 2020
Submission checks complete
On 06 Jun, 2020
Editor invited
On 06 Jun, 2020
No comments provided
Editorial decision: Revise before sending to peer reviewers
On 22 May, 2020
Editor assigned
On 05 May, 2020
Submission checks complete
On 04 May, 2020
Editor invited
On 04 May, 2020
First submitted
On 01 May, 2020
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This preprint is under consideration at BMC Public Health. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Parental mental health conditions and use of healthcare services in children the first year of life – a register-based, nationwide study
Signe Heuckendorff
Aalborg Universitetshospital
Corresponding Author
ORCiD: https://orcid.org/0000-0002-4074-064X
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 3
Posted 31 Dec, 2020
No community comments so far
Reviewer #2 agreed
On 07 Jan, 2021
Review #1 received
Received 03 Jan, 2021
Reviewer #1 agreed
On 16 Dec, 2020
Reviewers invited
Invitations sent on 13 Dec, 2020
Editor assigned
On 12 Dec, 2020
Submission checks complete
On 12 Dec, 2020
Editor invited
On 12 Dec, 2020
No comments provided
Editorial decision: Major revision
On 11 Nov, 2020
Review #2 received
Received 16 Oct, 2020
Review #3 received
Received 15 Oct, 2020
Reviewer #3 agreed
On 15 Oct, 2020
Reviewer #2 agreed
On 15 Oct, 2020
Review #1 received
Received 07 Sep, 2020
Reviewer #1 agreed
On 15 Aug, 2020
Reviewers invited
Invitations sent on 08 Jul, 2020
Editor assigned
On 07 Jun, 2020
Submission checks complete
On 06 Jun, 2020
Editor invited
On 06 Jun, 2020
No comments provided
Editorial decision: Revise before sending to peer reviewers
On 22 May, 2020
Editor assigned
On 05 May, 2020
Submission checks complete
On 04 May, 2020
Editor invited
On 04 May, 2020
First submitted
On 01 May, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Parental mental health conditions have been associated with increased morbidity and use of healthcare services in offspring. Existing studies have not examined different severities of parental mental health conditions, and the impact of paternal mental health has been overlooked.
We examined the association between two severities of parental mental health conditions and use of healthcare services for children during the first year of life and explored the impact of both maternal and paternal mental health conditions.
Methods
This register-based cohort study included all live-born children born in Denmark from 2000-2016. Information on socioeconomics, diagnoses, drug prescriptions, and healthcare contacts was extracted from nationwide public registries. Parents were grouped according to severity of mental condition based on the place of treatment of the mental health condition. Negative binominal regression analyses were performed to estimate the incidence rate ratio (IRR) of contacts to general practice (GP), out-of-hour medical service, emergency room (ER), and out- and inpatient hospital contacts during the first 12 months of the child’s life.
Results
The analyses included 964395 children. Twenty percent of the mothers and twelve percent of the fathers were identified with mental health conditions. Paternal mental health conditions were independently associated with increased risk of infant healthcare contacts (GP IRR 1.05 (CI95% 1.04-1.06) and out-of-hour IRR 1.20 (CI95% 1.18-1.22)). Risks were higher for maternal mental health conditions (GP IRR 1.18 (CI95% 1.17-1.19) and out-of-hour IRR 1.39 (CI95% 1.37-1.41)). The risks were even higher if both parents were classified with a mental health condition (GP IRR 1.25 (CI95% 1.23-1.27) and out-of-hour contacts IRR 1.49 (CI95% 1.45-1.54)), including minor mental health condition (GP IRR 1.22 (CI95% 1.21-1.24) and out-of-hour IRR 1.37 (CI95% 1.34-1.41)). This pattern was the same for all types of healthcare contacts.
Conclusions
Both maternal and paternal mental health conditions, including minor mental health conditions, were associated with increased utilization of healthcare services. Focus on both parents’ mental health conditions (even if minor) may be warranted in service planning.
Figure 1