Impact of Specialized Pediatric Palliative Care on Bereaved Parents' Mental and Physical Health

CONTEXT: Pediatric death can lead to long-term adverse effects on parents' health.

OBJECTIVES: To describe the trajectory of parental mental and physical health burden within 24 months before and after a child's death and to evaluate the impact of specialized pediatric palliative care (SPPC) and several a priori selected factors on new mental or physical health burden in bereaved parents within 12 months following the death of a child.

METHODS: Retrospective cohort study of biological parents of children (0-21 y) who died in or out of the hospital within 6 months of receiving care in the intensive care units (ICUs) of a free-standing quaternary care children's hospital in the Mountain West region between January 2013 and December 2019. Parental mental and physical health burden were assessed within 24 months before and after a child's death in six-month intervals. Multivariable logistic regression models evaluated the associations between new parental health burden within 12 months following a child's death with SPPC consultation and several a priori factors.

RESULTS: Of 776 deceased children linked to 773 mothers and 711 fathers, 36.1% received a SPPC consultation prior to death. Higher rates of mental and physical health burden were observed in mothers than fathers across all time points. Lack of SPPC was associated with increased risks for new mental and physical health burden for mothers within 12 months after the child's death (adjusted odds ratios [95% CIs] 1.77 [1.03-3.03] and 2.63 [1.07-6.46], respectively).

CONCLUSIONS: Bereaved parents, especially mothers, experienced new mental and physical health burden up to 24 months after a child's death. SPPC may be helpful in reducing the development of new health burdens in mothers within 12 months after a child's death.