Abstract
ObjectiveThe effects of suicidal behavior on obstetric outcomes remain dangerously unquantified. We sought to report on the risk of adverse obstetric outcomes for US women with suicidal behavior at the time of delivery.MethodsWe performed a cross-sectional analysis of delivery hospitalizations from 2007–2012 National (Nationwide) Inpatient Sample. From the same hospitalization record, International Classification of Diseases codes were used to identify suicidal behavior and adverse obstetric outcomes. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were obtained using logistic regression.ResultsOf the 23,507,597 delivery hospitalizations, 2,180 were complicated by suicidal behavior. Women with suicidal behavior were at a heightened risk for outcomes including antepartum hemorrhage (aOR = 2.34; 95% CI: 1.47–3.74), placental abruption (aOR = 2.07; 95% CI: 1.17–3.66), postpartum hemorrhage (aOR = 2.33; 95% CI: 1.61–3.37), premature delivery (aOR = 3.08; 95% CI: 2.43–3.90), stillbirth (aOR = 10.73; 95% CI: 7.41–15.56), poor fetal growth (aOR = 1.70; 95% CI: 1.10–2.62), and fetal anomalies (aOR = 3.72; 95% CI: 2.57–5.40). No significant association was observed for maternal suicidal behavior with cesarean delivery, induction of labor, premature rupture of membranes, excessive fetal growth, and fetal distress. The mean length of stay was longer for women with suicidal behavior.ConclusionDuring delivery hospitalization, women with suicidal behavior are at increased risk for many adverse obstetric outcomes, highlighting the importance of screening for and providing appropriate clinical care for women with suicidal behavior during pregnancy.
Highlights
Suicide is one of the leading causes of maternal mortality [1]
Women with suicidal behavior were at a heightened risk for outcomes including antepartum hemorrhage, placental abruption, postpartum hemorrhage, premature delivery, stillbirth, poor fetal growth, and fetal anomalies
Our analyses revealed that hospitalized women with suicidal behavior at delivery were at significantly higher risk for a variety of adverse obstetric outcomes including antepartum hemorrhage, placental abruption, postpartum hemorrhage, and premature delivery
Summary
Suicide is one of the leading causes of maternal mortality [1]. The strongest predictor of suicide is nonfatal suicidal thoughts and behaviors (hereafter referred to as suicidal behavior), which consists of suicidal ideation, plan, and attempt [2,3]. Five of the six studies have focused primarily on suicide attempt by drug overdose during pregnancy and teratogenic effects [7,8,9,10,11]. None of these six studies has evaluated the effect of suicidal ideation on pregnancy outcomes even though suicidal ideation is approximately 3.5 times more frequent than suicide attempt during pregnancy [12]. Due to sparse and inconsistent evidence on pregnancy outcomes, the effects of suicidal ideation or suicide attempt during pregnancy remain dangerously unquantified and under-studied
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
