Women who experience perinatal depression (depression during pregnancy or in the year following delivery) are at an elevated risk of suicide compared with women who do not experience depression during this time, according to a report published today in JAMA Network Open. The cohort study, based on analysis of records of nearly 1 million women in Sweden, found that this risk was highest during the first year after a diagnosis, though the risk remained elevated up to 18 years later.
“The findings highlight the pressing need for vigilant clinical monitoring and prompt intervention for this vulnerable population to prevent such devastating outcomes, regardless of prepregnancy history of psychiatric disorders,” wrote Han Yu, M.Sc., of Karolinska Institutet and colleagues.
For the study, Yu and colleagues analyzed data from multiple Swedish registers, including those containing records of prenatal care and delivery, diagnoses, filled prescriptions, and death. Women were categorized as having perinatal depression if they had a depression diagnosis recorded during pregnancy or within one year after delivery, or filled prescriptions for antidepressant medication during either period.
The researchers focused on women who gave birth between 2001 and 2017, including 86,551 women with perinatal depression. The researchers matched each woman with perinatal depression with 10 women who did not have perinatal depression (matched on age and year of delivery). Women were followed up from the matching date until the first suicide attempt and/or completion, death, emigration, or December 31, 2018, whichever occurred first.
Compared with the women who did not have perinatal depression, those with perinatal depression had a three times higher risk of suicidal behavior (hazard ratio [HR], 3.15). “Notably, the association was greater among women without a history of psychiatric disorders,” Yu and colleagues wrote.
Women with perinatal depression had a seven times higher risk of suicidal behavior during the first year after being diagnosed with perinatal depression, they continued. “Although declining over time, the risk remained doubled 5 or more years later (HR, 2.34).”
The authors concluded, “[T]he sustained risk over 18 years necessitates a paradigm shift in how we should approach [perinatal depression], advocating for extended monitoring and support beyond the perinatal period. Most importantly, the striking risk elevation of suicidal behavior within 1 year after [perinatal depression] reinforces the necessity of strategies that effectively detect early signs and act in a timely manner for suicide prevention.”
For related information, see the American Journal of Psychiatry article “Perinatal Mental Health: Advances and Opportunities.”
(Image: Getty Images/iStock/globalmoments)
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