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Women with postpartum psychiatric disorders at high-risk for suicide

Women with severe postpartum psychiatric disorders had higher risk for mortality than women with no psychiatric disorders, and suicide risk was particularly high during the first year post-diagnosis.

“Rare but tragic outcomes of untreated psychiatric disorders among new mothers include suicide, suicide attempts and infanticide. A limited number of studies have investigated the prognosis and long-term survival of women with specific postpartum psychiatric disorders, and reports have identified suicide as one of the primary causes of death among British mothers. In addition, Appleby et al documented a 70-fold increased risk of suicide within the first postpartum year in women with postpartum psychoses,” Benedicte Marie Winther Johannsen, BSc, of Aarhus University, Denmark, and colleagues wrote.

To determine mortality in women with first-onset severe psychiatric disorders following childbirth, researchers analyzed data from Danish population registers for women with first psychiatric inpatient or outpatient contact within 3 months postpartum (n = 2,699).

Overall, 96 women died during follow-up.

Mortality rate ratios were higher among women with postpartum psychiatric disorders (MRR = 3.74; 95% CI, 3.06-4.57) than those without postpartum-onset disorders (MRR = 2.73; 95% CI, 2.67-2.79), when compared with mothers with no psychiatric diagnoses.

However, women with psychiatric diagnoses and no children had the highest mortality rate ratio at 6.15 (95% CI, 5.94-6.38).

Unnatural causes of death accounted for 40.6% of deaths among women with postpartum psychiatric disorders.

Risk for suicide was significantly higher within the first year of psychiatric diagnosis (MRR = 289.42; 95% CI, 144.02-581.62), compared with women with no psychiatric history.

“The observed high relative risk of suicide in the postpartum period warrants special attention for this vulnerable group of women,” the researchers wrote. “Increased education and awareness among the general public about perinatal mental health issues are needed. Screening programs of new mothers can increase awareness by providing important psychoeducation to mothers and by alerting health care providers of women who are experiencing suicidal thoughts.” – by Amanda Oldt

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