家外照顾与终身过度死亡率相关。我们检查这种关联是否会受到第一次家外照顾安置的年龄和家外照顾的次数的影响。在这个基于人群的队列研究中，我们使用了覆盖了从1980年1月1日到1999年12月31日之间在丹麦出生的所有儿童的登记数据，共计1,111,193个个体，跟踪到2018年12月31日。我们根据性别、家外照顾状况、第一次安置的年龄和安置的次数将参与者分组。我们估计了18到39岁之间所有死亡和死于自杀、意外和癌症的调整危险比和以每1万人年为单位的危险差异。在18岁之前有4.8%的参与者被安置在家外照顾中。所有死亡的调整危险比是男性 3.4（95% CI 3.1-3.7），女性为 4.7（4.0-5.4），对应于男性和女性每年每10,000个个体额外死亡的人数分别为20.6（19.0-22.2）和10.3（9.1-11.5）。根据第一次安置的年龄或安置的次数，相关性并没有发生重大变化。历经家外照顾的男性和女性与同龄人相比更容易死于自杀、意外和癌症。我们发现经历家外照顾的儿童总体和因特定原因的死亡率明显较高，但与我们的假设相反，第一次安置的年龄和安置的次数没有改变这种关系。这些结果需要进一步研究可能预防该劣势个体族群早逝的干预靶点。© 2023。Springer Nature B.V.

Out-of-home care has been linked to excess mortality across the lifespan. We examined whether this association is modified by the age at first out-of-home care placement and the number of placements. In this population-based cohort study, we used register data covering all children born in Denmark between 1 and 1980 and 31 December 1999, totalling 1,111,193 individuals followed until 31 December 2018. We divided participants according to sex, out-of-home care status, age at first placement, and the number of placements. We estimated adjusted hazard ratios and hazard differences per 10,000 person-years for all-cause mortality and mortality due to suicide, accidents, and cancer between ages 18 and 39. 53,015 (4.8%) of the participants were placed in out-of-home care before age 18. The adjusted hazard ratio for all-cause mortality was 3.4 (95% CI 3.1-3.7) for males and 4.7 (4.0-5.4) for females, corresponding to 20.6 (19.0-22.2) and 10.3 (9.1-11.5) additional deaths per 10,000 individuals annually among males and females, respectively. Associations did not vary substantially according to age at first placement or the number of placements. Both males and females with a history of out-of-home care were more likely to die from suicide, accidents, and cancer compared with their peers. We show a markedly higher all-cause and cause-specific mortality among children who have been placed in out-of-home care, but contrary to our hypothesis, age at first placement and the number of placements did not modify this relation. These results warrant further investigation into potential target points for interventions that may prevent premature mortality in this group of disadvantaged individuals.© 2023. Springer Nature B.V.