Keeping Tabs on Perinatal Risk for Suicide

Allison Bryant, MD, MPH reviewing Kim JJ et al. Obstet Gynecol 2015 Apr.

A small but important proportion of pregnant and postpartum women are at high risk for active suicidal ideation.

Attention has increasingly focused on maternal death in the U.S., one of a handful of countries with rising maternal mortality. While many safety campaigns have focused on the most common causes of death in women during and after pregnancy, less emphasis has been placed on “hidden” causes of maternal death such as suicide and homicide. To examine correlates of positive screens for suicidal thought, researchers analyzed data from a single suburban health system that routinely administers questionnaire-based depression screens during pregnancy and postpartum.

Suicidal ideation was reported in 4% of >22,000 questionnaires. Younger, unmarried, nonwhite women and non-English speakers were more likely to report thoughts of self-harm, as were those with preexisting psychiatric diagnoses. Among women with positive screens, most (58%) had some degree of suicidal thought, 16% had prior histories of suicidality, 13% misunderstood the question about self-harm (often due to language barriers), and 1% had active ideation with a plan, intent, and means to attempt suicide.

CITATION(S):

Kim JJ et al. Suicide risk among perinatal women who report thoughts of self-harm on depression screens. Obstet Gynecol 2015 Apr; 125:885.