The association between a history of self-harm and mental disorders in pregnancy

Abstract

Self-harm is prevalent, particularly among young women, and is associated with mental disorders. However, little is known about the mental health of pregnant women who have a history of self-harm. This study examined whether lifetime self-harm was associated with increased risk of antenatal mental disorders. Cross-sectional study of 544 pregnant women recruited after their first antenatal appointment, oversampling those who responded positively to the depression-screening Whooley questions. The Structured Clinical Interview for DSM-IV-TR was delivered, including questions about the lifetime occurrence of self-harm. The associations between lifetime self-harm and the presence of mental disorders, and more specifically anxiety and depressive disorders, were examined using survey-weighted logistic regression. The association between lifetime self-harm and symptoms of personality disorder, was investigated using survey-weighted linear regression. After survey weighting, history of self-harm had a prevalence of 7.9% (95%CI 5.5-11.2%) and was associated with increased risk for mental disorders in early pregnancy (adjusted odds ratio [AOR] 5.03; 95%CI: 2.22-11.37; p<0.0001; n = 517). Women with a history of self-harm were more likely to experience antenatal anxiety disorders (AOR 4.41; 95%CI: 1.85-10.51; p = 0.001; n = 517) and antenatal depression (AOR 2.71; 95%CI: 1.04-7.05; p = 0.042; n = 517) than women who did not report self-harm. History of self-harm was also associated with higher SAPAS scores (adjusted coefficient 0.69; 95%CI: 0.21-1.17; n = 517). Information on the timing and persistence of self-harm was not available. Women with a history of self-harm are more vulnerable to mental disorders in pregnancy. Further research should include more comprehensive assessments of self-harm and the social context of pregnant women.