Prevalence and Correlates of Suicide Ideation and Attempt among Pregnant Women Attending Antenatal Care Services at Public Hospitals in Southern Ethiopia

Abstract

Background: Suicide ideation and attempt are common among pregnant women, risk factors for completed suicide, and associated adverse maternal and fetal outcomes. It is under-recognized and has not been investigated well in low-income countries like Ethiopia. This study aimed to assess the prevalence and factors associated with suicide ideation and attempt among pregnant women attending antenatal care services at public hospitals in southern Ethiopia. Methods: A group of 762 pregnant women who were attending the antenatal service at public hospitals in Hawassa, southern Ethiopia, selected by a systematic random sampling technique, took part in an interview. A Composite International Diagnostic Interview (CIDI) was used to measure suicide ideation and attempt. Chi-square and binary logistic regression analyses were performed to identify the associated factors. An adjusted odds ratio with a 95% confidence interval was used for reporting the result with a p-value<0.05 statistical significance level. Results: The prevalence of suicide ideation and attempt among pregnant women was 11.8% and 2.7%, respectively. Unplanned pregnancy (AOR=2.01, 95% CI=1.04-3.88), poor social support (AOR=3.29, 95% CI=1.62-6.68), common mental disorders (AOR=2.77, 95% CI=1.50-5.09), and lifetime suicide ideation (AOR=4.63, 95% CI=2.63-8.16) were factors significantly associated with suicide ideation. Social support was the only correlated factor with suicide attempt among pregnant mothers. Conclusion:The prevalence of suicide ideation and attempt among pregnant women was found to be high. Intervention strategies towards suicidal ideation and attempt should consider improving social support and antenatal related common mental disorders with a primary focus on women with unplanned pregnancy and prior history of suicide ideation.

Prevalence and associated factors of suicidal behavior among pregnant mothers in southern Ethiopia: a cross-sectional study

“…The current study showed that about 9.3% with 95% CI (7.1-11.9) of pregnant mothers had suicidal behavior in communities. The finding of this study was similar to an institutional-based study conducted in Hawassa, Ethiopia in which 11.8% of pregnant mothers had suicidal ideation [ 34 ].…”

Maternal Suicide Ideation and Behaviour During Pregnancy and the First Postpartum Year: A Systematic Review of Psychological and Psychosocial Risk Factors

“…Twenty-four studies ( 28 , 40 , 43 , 44 , 46 , 48 , 54 – 56 , 59 – 61 , 65 , 67 , 75 , 77 – 85 ) assessed social support, yet the types of social support (e.g., material, emotional, informational, affective, and social interaction) and sources of support (e.g., partner, family, friends, and neighbours) varied across these studies. With regards to the 16 studies that measured social support and suicide/self-harm ideation alone, seven studies found no association ( 48 , 67 , 80 – 82 , 84 , 85 ), six ( 40 , 43 , 44 , 59 – 61 ) reported a significant association (i.e., poor social support increased the odds), and three ( 75 , 78 , 79 ) found a significant protective effect of social support (i.e., good-quality support reduced the odds).…”

“…Seven studies investigated social support and suicidal ideation and behaviour ( 46 , 54 – 56 , 65 , 77 , 83 ) with mixed findings, although it should be noted that most of these studies used a different self-report measure of social support. Only Belete and Misgan ( 56 ) and Belete et al ( 77 ) used the same measure of social support, namely, the Oslo-3 Social Support Scale ( 87 ) which asks: “ how many people are you so close to that you can count on them if you have great personal problems? ,” “ how much interest and concern do people show in what you do?…”

Suicide and Maternal Mortality

“…In perinatal populations, younger age, being unmarried, and marital dissatisfaction are risk factors [ 13 , 26 , 59 , 60 , 63 ], while social support and cohabitation with partner are associated with reduced odds of suicidality [ 61 , 62 ]. In a study of 762 pregnant Ethiopian women, poor social support was the only variable to have been significantly correlated with suicide attempt during pregnancy [ 64 ].…”

“…Suicidal ideation was positively correlated with subjective sleep quality, sleep duration, and daytime function and negatively correlated with IGT scores Belete and Misgan [ 67 ] Suicidal behavior in postnatal mothers in northwestern Ethiopia: a cross-sectional study Cross-sectional Mothers > 18 years old in routine postnatal care 1065 mothers N/A SA The prevalence of suicidal behavior (SI, plan, or attempt) was 14% in postpartum mothers. Poor wealth of the mother, unplanned pregnancy of the current child, history of rape, and sickness of the new child were significantly associated with suicidal behaviors Belete et al [ 64 ] Prevalence and Correlates of Suicidal Ideation and Attempt among Pregnant Women Attending Antenatal Care Services at Public Hospitals in Southern Ethiopia Cross-sectional 762 pregnant women attending antenatal services at public hospitals in Hawassa southern Ethiopia, selected by systematic random sampling technique 762 pregnant women CIDI SI and SA The prevalence of suicidal ideation among pregnant women was 11.8% and suicide attempt was 2.7%. Unplanned pregnancy, poor social support, common mental disorders, and lifetime suicidal ideation were significantly associated with SI.…”