The Prevalence and Correlates of Self-Harm in the Perinatal Period

Ayre, Karyn; Gordon, Hannah; Dutta, Rina; Hodsoll, John; Howard, Louise M.

doi:10.4088/jcp.19r12773

Cited by 26 publications

(31 citation statements)

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“…Self‐harm in the perinatal period has only recently been highlighted as a public mental health issue 46 . A systematic review of 39 studies (reporting on 19,191,431 pregnancies) 47 found that perinatal self‐harm is relatively rare (though this may partly reflect detection bias) other than in women with severe mental illness. Indeed, in a study using secondary care electronic health records of women with psychotic mood disorder and schizophrenia, 8% self‐harmed during pregnancy 48 .…”

Section: Association Between Perinatal Mental Disorders and Maternal mentioning

confidence: 99%

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Perinatal mental health: a review of progress and challenges

2020

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Perinatal mental health has become a significant focus of interest in recent years, with investment in new specialist mental health services in some high‐income countries, and inpatient psychiatric mother and baby units in diverse settings. In this paper, we summarize and critically examine the epidemiology and impact of perinatal mental disorders, including emerging evidence of an increase of their prevalence in young pregnant women. Perinatal mental disorders are among the commonest morbidities of pregnancy, and make an important contribution to maternal mortality, as well as to adverse neonatal, infant and child outcomes. We then review the current evidence base on interventions, including individual level and public health ones, as well as service delivery models. Randomized controlled trials provide evidence on the effectiveness of psychological and psychosocial interventions at the individual level, though it is not yet clear which women with perinatal mental disorders also need additional support for parenting. The evidence base on psychotropic use in pregnancy is almost exclusively observational. There is little research on the full range of perinatal mental disorders, on how to improve access to treatment for women with psychosocial difficulties, and on the effectiveness of different service delivery models. We conclude with research and clinical implications, which, we argue, highlight the need for an extension of generic psychiatric services to include preconception care, and further investment into public health interventions, in addition to perinatal mental health services, potentially for women and men, to reduce maternal and child morbidity and mortality.

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Section: Association Between Perinatal Mental Disorders and Maternal mentioning

confidence: 99%

“…Self‐harm history is an important mark‐er for perinatal mental disorders 49,50 , and is associated with adverse obstetric and neonatal outcomes 47 . However, it is not routinely asked about in women during pregnancy and postpartum.…”

Section: Association Between Perinatal Mental Disorders and Maternal mentioning

confidence: 99%

Perinatal mental health: a review of progress and challenges

2020

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“…[24] Furthermore, suicide is a leading cause of death during the first postnatal year, [25] and has devastating effects not only for the expectant or new mother, her fetus or newborn, but also her partner, other children and family. [26] Regardless of this strong justification for supporting early screening, finding a balance between the need to screen and detect risk while limiting public healthcare burden, will likely be key to the acceptability and feasibility of increased screening in public healthcare clinical settings. Some research in SA has already advocated for ultra-short screening in primary healthcare settings, [27] and while we provide support for those calls, our findings suggests that focusing only on depressive screening items may have limitations.…”

Section: Researchmentioning

confidence: 99%

Thoughts of self-harm in early and late pregnancy in urban South Africa: Investigating prevalence, predictors and screening options

et al. 2021

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“…Self-harm ideation (SHI) involves thoughts of poisoning or inflicting injuries on oneself, with or without fatal intent, and is an important risk factor for repeated SHI episodes and suicide [8,9]. Although the prevalence of SHI differs depending on the mental illness considered, case ascertainment methods, and geography, up to one in five women with a psychiatric disorder may experience an event of SHI in the postpartum period [10]. This high estimate is alarming as SHI causes direct harm to the mother, may impair her ability to care for the child, and disrupts the welfare of the family as a whole [11].…”

Section: Introductionmentioning

confidence: 99%

“…5-2.4). Yet, the preventative association of antidepressant treatment in pregnancy on postpartum SHI has never been explored before, despite the call for more research on this topic [7,10,23]. Addressing this knowledge gap is important, as it can aid clinicians and women in weighing possible risks of antidepressant medication in pregnancy against their benefits to mental health, and thereby facilitate a more informed decision-making about pharmacotherapy in pregnancy in women with ongoing psychiatric illness [7,24].…”

Section: Introductionmentioning

confidence: 99%

Association between Antidepressant Treatment during Pregnancy and Postpartum Self-Harm Ideation in Women with Psychiatric Disorders: A Cross-Sectional, Multinational Study

Vallee

Wong

Mannino

et al. 2020

IJERPH

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This study sought to estimate whether there is a preventative association between antidepressants during pregnancy and postpartum self-harm ideation (SHI), as this knowledge is to date unknown. Using the Multinational Medication Use in Pregnancy Study, we included a sample of mothers who were in the five weeks to one year postpartum period at the time of questionnaire completion, and reported preexisting or new onset depression and/or anxiety during pregnancy (n = 187). Frequency of postpartum SHI (‘often/sometimes’ = frequent, ‘hardly ever’ = sporadic, ‘never’) was measured via the Edinburgh Postnatal Depression Scale (EPDS) item 10, which reads “The thought of harming myself has occurred to me”. Mothers reported their antidepressant use in pregnancy retrospectively. Overall, 52.9% of women took an antidepressant during pregnancy. Frequent SHI postpartum was reported by 15.2% of non-medicated women and 22.0% of women on past antidepressant treatment in pregnancy; this proportion was higher following a single trimester treatment compared to three trimesters (36.3% versus 18.0%). There was no preventative association of antidepressant treatment in pregnancy on reporting frequent SHI postpartum (weighted RR: 1.90, 95% CI: 0.79, 4.56), relative to never/hardly ever SHI. In a population of women with antenatal depression/anxiety, there was no preventative association between past antidepressant treatment in pregnancy and reporting frequent SHI in the postpartum year. This analysis is only a first step in providing evidence to inform psychiatric disorder treatment decisions for pregnant women.

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The Prevalence and Correlates of Self-Harm in the Perinatal Period

Cited by 26 publications

References 0 publications

Perinatal mental health: a review of progress and challenges

Perinatal mental health: a review of progress and challenges

Thoughts of self-harm in early and late pregnancy in urban South Africa: Investigating prevalence, predictors and screening options

Association between Antidepressant Treatment during Pregnancy and Postpartum Self-Harm Ideation in Women with Psychiatric Disorders: A Cross-Sectional, Multinational Study

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