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Untreated depression increases risk for suicide in new, expectant mothers

Among women in contact with psychiatric services in the United Kingdom, suicides in the perinatal period were more likely among those diagnosed with depression and no active treatment at time of death.

“Suicide is an important cause of death during pregnancy and the first postnatal year, accounting for about 5% to 20% of maternal deaths in high-income countries, and 1% to 5% in low-income and middle-income countries. National inquiries have repeatedly called for improved detection and management of suicide risk in perinatal (pregnant and postpartum) women,” the researchers wrote.

Using data from the United Kingdom National Confidential Inquiry into Suicides and Homicides by People from Mental Illness for 1997 through 2012, researchers compared trends, nature and correlates of suicide in perinatal and nonperinatal women in contact with psychiatric services within the past year. The study cohort included 4,785 women aged 16 to 50 years who died by suicide.

Overall, 2% of the cohort died during the perinatal period. Among women aged 20 to 35 years, 4% died during the perinatal period.

During the study period, researchers observed a downward trend in mean number of women dying by suicide in the nonperinatal period (–2.07 per year; P = .026) but not the perinatal period (–0.07 per year; P = .58).

Women who died by suicide in the perinatal period were more likely to be diagnosed with depression (adjusted OR = 2.19; 95% CI, 1.43-3.34; P < .001) and less likely to be receiving active treatment at time of death (aOR = 0.46; 95% CI, 0.24-0.89; P = .022), compared with nonperinatal women.

Furthermore, women who died by suicide during the perinatal period were more likely to be younger (OR = –6.39; 95% CI, –8.15 to –4.62; P < .0001), married (OR = 4.46; 95% CI, 2.93-6.8; P < .0001), with shorter illness duration (OR = 2.93; 95% CI, 1.88-4.56; P < .001) and no history of alcohol abuse (OR = 0.47; 95% CI, 0.24-0.92; P = .027).

Researchers found no differences in service contract or treatment adherence.

“In conclusion, our findings show that roughly one in 50 female suicides were in new or expectant mothers. Suicide in this group was often violent and more likely to occur in women with a depression diagnosis and recent illness onset, with a substantial minority not receiving follow-up or treatment at the time of death,” the researchers wrote. “Assertive follow-up and treatment of women who are under the care of mental health services in the perinatal period is needed to address suicide risk in this group.” – by Amanda Oldt

Disclosure: Khalifeh reports no relevant financial disclosures. Please see the full study for a list of all authors’ relevant financial disclosures.