Risk of Cardiovascular Disease in Parents of Children Diagnosed With Neurodevelopmental Disorders

Importance: Evidence regarding the association between having children with neurodevelopmental disorders (NDDs) and parental cardiovascular disease (CVD) risk is lacking. Objective: To investigate whether parents of children diagnosed with common NDDs have increased risk of CVD. Design, Setting, and Participants: This cohort study used linked national register data of parents in Sweden with at least 1 live singleton birth between January 1, 1987 and December 31, 2014. Parents were followed up from the birth of the first child until the first diagnosis of CVD, death, emigration from Sweden, or December 31, 2023, whichever came first. Data were analyzed from April 1 to September 30, 2025. Exposure: Offspring NDDs. Main Outcomes and Measures: Parental CVD was identified from Sweden's National Patient Register and the Cause of Death Register. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% CIs for any and specific types of CVD among parents by offspring NDDs. Results: The study sample included 1 180 457 mothers (mean [SD] age, 49.3 [9.1] years) and 882 619 fathers (mean [SD] age, 51.2 [8.8] years). A total of 196 840 mothers (16.7%) and 168 582 fathers (19.1%) were diagnosed with any CVD during a median (IQR) follow-up of 16.7 (10.9-25.3) years and 16.6 (11.0-24.6) years, respectively. Compared with parents who did not have a child diagnosed with NDDs, parents of children with NDDs had an increased risk of any CVD (mothers: HR, 1.27 [95% CI, 1.25-1.29]; fathers: HR, 1.20 [95% CI, 1.18-1.22]). CVD risk in parents increased with the number of affected children. Among mothers, the HRs for CVD risk were 1.22 (95% CI, 1.20-1.24), 1.39 (95% CI, 1.35-1.44), and 1.66 (95% CI, 1.56-1.77) for 1, 2, or 3 or more children with NDDs, respectively. Among fathers, the corresponding HRs were 1.16 (95% CI, 1.14-1.18), 1.33 (95% CI, 1.28-1.37), and 1.50 (95% CI, 1.40-1.61), respectively. The associations were observed for all 3 NDDs and for the most common types of CVD. The risk tended to be higher if the affected child also had comorbid conditions. The results remained consistent in the sibling comparison analysis. Conclusions and relevance: This Swedish registry-based cohort study found that having children with NDDs was associated with an increased subsequent risk of CVD in parents. If confirmed by future studies, these findings may support the need for enhanced care and early cardiovascular risk monitoring in affected parents.