Suicidal ideation, intentional self-harm increased among pregnant, postpartum women
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The prevalence of suicidal ideation and intentional self-harm during the year before or after birth increased significantly among childbearing individuals over a 12-year period, according to study results published in JAMA Psychiatry.
“We hoped to characterize the prevalence and trends in suicidality among pregnant and postpartum women since we thought information on this topic remained thin and limited,” Kara Zivin, PhD, MS, MA, of the department of psychiatry at the University of Michigan, told Healio Psychiatry.
Results of prior studies demonstrated that suicide is a leading cause of maternal mortality in the United States. Specifically, a 2017 report aggregated data from nine maternal mortality review committees and highlighted maternal suicide as having accounted for 6.5% of maternal deaths between 2008 and 2017.
In the current serial cross-sectional study, Zivin and colleagues analyzed data of 595,237 childbearing individuals aged 15 to 44 years who were continuously enrolled in a single commercial health insurance plan in the U.S. between January 2006 and December 2017. Diagnosis of suicidality among childbearing individuals 1 year before or after birth according to the identification of relevant ICD-9-CM and ICD-10-CM diagnosis codes during at least one inpatient or two outpatient visits served as the primary outcome.
The mean age at delivery was age 31.9 years. A total of 6.8% of participants were Asian, 8.6% were Black, 12.1% were Hispanic, 63.1% were white and 9.5% had unknown or missing race/ethnicity data. Results showed a total of 698,239 deliveries among this population and 2,714 diagnoses of suicidality 1 year before or after giving birth. Suicidal ideation prevalence increased from 0.1% per 100 individuals in 2006 to 0.5% per 100 individuals in 2017, for a difference of 0.4%. During the same timeframe and among the same population size, the researchers also noted the following:
- intentional self-harm prevalence increased from 0.1% to 0.2%;
- suicidality prevalence increased from 0.2% to 0.6%; and
- diagnoses of suicidality with comorbid bipolar or psychotic disorders increased from 6.9% to 16.9%.
The researchers observed larger increases in suicidality over the study period among non-Hispanic Black individuals, individuals with a lower income and younger individuals.
“These findings reiterate the importance of both regular mental health screening and follow-up at multiple time points during pregnancy and postpartum,” Zivin said.