Perinatal suicide in Ontario, Canada: a 15-year population-based study

Abstract

BACKGROUND:Death by suicide during the perinatal period has been understudied in Canada. We examined the epidemiology of and health service use related to suicides during pregnancy and the first postpartum year. METHODS:In this retrospective, population-based cohort study, we linked health administrative databases with coroner death records (1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008) for Ontario, Canada. We compared sociodemographic characteristics, clinical features and health service use in the 30 days and 1 year before death between women who died by suicide perinatally, women who died by suicide outside of the perinatal period and living perinatal women.

Postpartum self-inflicted injury, suicide, assault and homicide in relation to immigrant status in Ontario: a retrospective population-based cohort study

“…The overall rate of self-inflicted injury in this study was similar to rates reported previously in high-income countries such as the United States and the United Kingdom but no previous studies on self-inflicted injury in immigrant women were identified for comparison. 4,30,31 Since immigrant women have high rates of postpartum depression, a major risk factor for suicidality, the reason why the risk for this outcome was not elevated in immigrant women is unclear. 15,32,33 The causes of severe postpartum mental illness (i.e., illness that might result in suicidality) may be mediated more by biological (i.e., genetic sensitivity to rapid hormonal shifts) than socioenvironmental stressors.…”

“…1 Suicidal thoughts are common among women after they give birth, affecting as many as 9% of women, 2 and suicide accounts for a high proportion of maternal deaths globally. 1,3,4 Assault, mainly by intimate partners, affects up to about 13% of women perinatally 5 and is also responsible for some maternal mortality. [6][7][8][9] Immigrant women contribute one-quarter to one-third of births in high-income countries, 10 but their risk for intentional injury in the postnatal period is unknown.…”

Associations of antepartum suicidal behaviour with adverse infant and obstetric outcomes

“…3,4 Knowledge about the epidemiology of suicidal behaviour during pregnancy, including the causes and consequences of suicidal behaviour, is critical to inform suicide prevention strategies for pregnant women, and ultimately to reduce maternal mortality. 5 Although suicidal behaviour in pregnancy has been studied for decades, very few studies [6][7][8][9][10][11][12][13] have provided information on the associations of antepartum suicidal behaviour with infant and obstetric outcomes. 10,12 The majority of past studies have focused on suicide attempt by drug overdose.…”

“…Nonfatal suicidal thoughts and behaviours (hereafter referred to as “suicidal behaviour”), including suicidal ideation, plan, and attempt, are the strongest predictor of suicide . Knowledge about the epidemiology of suicidal behaviour during pregnancy, including the causes and consequences of suicidal behaviour, is critical to inform suicide prevention strategies for pregnant women, and ultimately to reduce maternal mortality …”

Postpartale psychische Störungen und ihre Bedeutung für die Wochenbettbetreuung

“…Suizid ist die häufigste Todesursache unter Müttern innerhalb eines Jahres nach der Geburt [35]. Nur wenige Studien haben sich bisher mit dem Suizid von Müttern nach der Geburt beschäftigt.…”