Maternal Mental Disorders Affect Primary School Completion in Offspring

sad girl sitting and thinking in the classroom
Maternal mental disorders and the timing of their onset are associated with completion of primary education in offspring.

Offspring of mothers with maternal mental disorders were at greater risk of not completing primary education, according to study data published in JAMA Psychiatry.

Investigators conducted a population-based cohort study from January 1, 1996, to December 31, 2014, using data from the Danish Civil Registration System, the Danish Central Psychiatric Research Register, and the Primary Education Register. Children born and living in Denmark from January 1, 1986, to December 31, 1996, were selected for inclusion. Exposure to maternal mental disorders was determined using maternal records, if available, from the Danish Psychiatric Central Research Register. Timing of maternal disorder onset was defined as the first date of first psychiatric admission. Completion of primary education was categorized if records of the child’s grades or test results were available in the Primary Education Register; “no completion” was categorized if such records were absent. To assess the effect of maternal mental illness exposure on primary education completion, a Wald 2-sided test was conducted.

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The final study cohort comprised 684,248 children (51.3% boys), among whom 45,196 (6.6%) did not complete primary education before 18 years of age. Children of mothers with mental disorders were more likely to not complete primary education compared with children of mothers without recorded mental disorders. The risk of not completing primary education was greatest when onset of maternal mental disorder occurred before pregnancy (adjusted odds ratio [aOR], 1.95; 95% CI, 1.85-2.06). The association between maternal mental illness and completion of primary education remained significant if onset of maternal disorder was observed during pregnancy (aOR, 1.64; 95% CI, 1.25-2.17), during the first year after birth (aOR, 1.40; 95% CI, 1.19-1.64), or within 1 to 16 years after birth (aOR, 1.47; 95% CI, 1.42-1.52). These analyses were adjusted for maternal age at birth and mental disorders in the children and fathers.

Investigators were unable to adjust for the severity of maternal illness and child’s IQ as confounders.

The strong association between timing of maternal mental disease onset and the likelihood of completing primary education warrants additional research. Investigators hypothesized that intrauterine stress and exposure to medication may affect the developing fetus, although many additional factors, including home environment and adverse life events, also play a role.


Ingstrup KG, Laursen TM, Bergink V, Ranning A, Munk-Olsen T. Association of timing of onset of maternal mental disorders with completion of primary education in offspring [published online March 20, 2019]. JAMA Psychiatry. doi:10.1001/jamapsychiatry.2019.0041