Worldwide prevalence of suicide attempt in pregnant and postpartum women: a meta-analysis of observational studies

Rao, Wenwang; Yang, Yuan; Tian, Jing; Zhang, Qinge; Ungvári, Gábor S.; Hall, Brian J.; Xiang, Yu Tao

doi:10.1007/s00127-020-01975-w

Cited by 20 publications

(16 citation statements)

References 59 publications

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“…Fourth, the observed incidence of prepartum (0.15%) and postpartum (0.01%) suicide attempts appeared to be lower than expected from previous reports. A meta-analysis estimated the pooled prevalence of suicide attempts in 0.10% to 4.69% of pregnant women and 0.01% to 3.21% in postpartum women . This discrepancy could have been derived from the design of this study.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors Associated With Peripartum Suicide Attempts in Japan

et al. 2023

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ImportancePeripartum suicide attempt is a major psychiatric complication associated with pregnancy, but the risk factors remain largely uncertain.ObjectiveTo identify the demographic characteristics and predisposing risks for peripartum suicide attempts and postpartum depression.Design, Setting, and ParticipantsThis cohort study used retrospective data on pregnant women who delivered children between April 1, 2016, and March 31, 2021, at 712 hospitals in Japan. The nationwide Diagnosis Procedure Combination database was used.ExposuresPsychiatric and nonpsychiatric medical history, age, alcohol and tobacco use, and obstetric complications and procedures.Main Outcomes and MeasuresData on admissions for prepartum suicide attempt and delivery during the same hospital stay and readmissions for depression or suicide attempt within 1 year post partum were collected. Comparisons of prevalence of each study variable were performed, and multivariable logistic regression analyses were used to determine risk factors.ResultsFrom a total of 39 908 649 hospitalization episodes, 804 617 cumulative pregnant women (median [IQR] age at childbirth, 33 [29-36] years) who delivered at the enrolled hospitals were identified, including 1202 who were admitted for suicide attempt and delivery during the same hospital stay and 111 readmitted for suicide attempt within 1 year post partum. Risk factors associated with prepartum suicide attempts included younger age (adjusted odds ratio [aOR], 0.99; 95% CI, 0.98-1.00) and histories of personality disorder (aOR, 10.81; 95% CI, 5.70-20.49), depression (aOR, 3.97; 95% CI, 2.35-6.70), schizophrenia (aOR, 2.89; 95% CI, 1.52-5.50), and adjustment disorder (aOR, 2.66; 95% CI, 1.07-6.58). Risk factors associated with postpartum suicide attempts included younger age (aOR, 0.96; 95% CI, 0.93-1.00), heavy tobacco use (aOR, 23.09; 95% CI, 5.46-97.62), and histories of alcohol use disorder (aOR, 163.54; 95% CI, 28.30-944.95), personality disorder (aOR, 10.28; 95% CI, 3.29-32.10), anxiety disorders (aOR, 8.13; 95% CI, 2.88-22.98), depression (aOR, 7.27; 95% CI, 2.95-17.91), schizophrenia (aOR, 5.77; 95% CI, 2.17-15.38), bipolar disorder (aOR, 3.98; 95% CI, 1.36-11.67), and insomnia (aOR, 3.17; 95% CI, 1.30-7.78). On sensitivity analysis, risk factors associated with postpartum depression after excluding those with prenatal depression included histories of personality disorder, adjustment disorder, bipolar disorder, insomnia, and anxiety disorders.Conclusions and RelevanceThe findings of this cohort study suggest that histories of smoking and prenatal psychiatric disorders are potential risk factors for peripartum suicide attempts and may require additional treatment and prevention interventions.

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Section: Discussionmentioning

confidence: 99%

Risk Factors Associated With Peripartum Suicide Attempts in Japan

et al. 2023

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“…A systematic review of 14 studies including 6,406,245 pregnant and postpartum women found that the pooled worldwide prevalence of suicide attempts was 680 per 100,000 (95% confidence interval 0.10–4.69%) during pregnancy and 210 per 100,000 (95% confidence interval 0.01–3.21%) during the first year postpartum [ 44 ]. Among pregnant and postpartum adolescents in Bangladesh, 6.5% (61/940) reported suicide attempts in the past 12 months, with the majority (88.5%) of the attempts occurring in the first postpartum year [ 45 ].…”

Section: Prevalence Of Perinatal Suicide and Perinatal Suicidalitymentioning

confidence: 99%

“…In Switzerland, the suicide rate of women aged 15–44 years was 3.6/100,000 females; the suicide rate in relation to pregnancy and delivery was 1.65 per 100,000 live births Phukata and Omole [ 134 ] Prevalence and risk factors associated with postnatal depression in a South African primary care facility Cross-sectional Postnatal women in Levai Mbatha Community healthcare center in Evaton, South of Gauteng 227 EPDS SI 38.8% of participants screened positive for postnatal depression. 32.5% of participants scored between 1 and 3 on Question 10 of EPDS "The thought of harming myself or my baby has occurred to me" Rao et al [ 44 ] Worldwide prevalence of suicide attempts in pregnant and postpartum women: a meta-analysis of observational studies Meta-analysis Pregnant and postpartum women 6,406,245 N/A SA 14 studies were included. The prevalence of suicide attempt was 680 per 100,000 during pregnancy (95% CI 0.1–4.69%) and 210 per 100,000 during the first year postpartum (95% CI 0.01–3.21%).…”

Section: Introductionmentioning

confidence: 99%

Suicide and Maternal Mortality

Chin

Wendt

Bennett

et al. 2022

Curr Psychiatry Rep

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Purpose of Review Suicide is a leading cause of death in the perinatal period (pregnancy and 1 year postpartum). We review recent findings on prevalence, risk factors, outcomes, and prevention and intervention for suicide during pregnancy and the first year postpartum. Recent Findings Standardization of definitions and ascertainment of maternal deaths have improved identification of perinatal deaths by suicide and risk factors for perinatal suicide. Reports of a protective effect of pregnancy and postpartum on suicide risk may be inflated. Clinicians must be vigilant for risk of suicide among their perinatal patients, especially those with mental health diagnoses or prior suicide attempts. Summary Pregnancy and the year postpartum are a time of increased access to healthcare for many, offering many opportunities to identify and intervene for suicide risk. Universal screening for suicide as part of assessment of depression and anxiety along with improved access to mental health treatments can reduce risk of perinatal suicide.

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“…Increasing attention is being paid to mood disorders in pregnancy and postpartum. Recent publications have highlighted the fact that suicide during the perinatal period, although rare compared with the prevalence in the general population, 1 accounts for 6.5% of maternal deaths 2 . In California, drug overdoses, closely linked with depression, and suicide are the second and seventh leading causes of maternal deaths, respectively 3 .…”

Section: Toscano M Royzer R Castillo D Li D Poleshuck E Prevalence Of Depression or Anxiety During Antepartum Hospitalizations For Obstetmentioning

confidence: 99%

Current Resources for Evidence‐Based Practice, July/August 2021

Barger

2021

J Midwife Womens Health

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Worldwide prevalence of suicide attempt in pregnant and postpartum women: a meta-analysis of observational studies

Cited by 20 publications

References 59 publications

Risk Factors Associated With Peripartum Suicide Attempts in Japan

Risk Factors Associated With Peripartum Suicide Attempts in Japan

Suicide and Maternal Mortality

Current Resources for Evidence‐Based Practice, July/August 2021

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