Psychiatric risk factors associated with postpartum suicide attempt in Washington State, 1992-2001

Objective

The purpose of this study was to evaluate preexisting psychiatric risk factors for postpartum suicide attempts resulting in hospitalization.

Study Design

We performed a population-based case-control study using Washington State birth certificates linked to hospital discharge data to evaluate the association between hospitalization with a psychiatric diagnosis, substance use diagnosis, or dual diagnosis in the 5 years before delivery with risk of postpartum suicide attempt. We compared cases (n = 355) hospitalized postpartum for a suicide attempt with controls (n = 1420) by using multivariable logistic regression.

Results

Women with a psychiatric disorder were at a 27.4-fold (95% confidence interval 10.6-70.8) increased risk, and those with a substance use disorder were at a 6.2-fold (95% confidence interval 2.8-13.9) increased risk, and those with a dual diagnosis were at an 11.1-fold (95% confidence interval 5.1-24.2) increased risk of postpartum suicide attempt compared with controls.

Conclusion

Prenatal screening for preexisting psychiatric or substance abuse diagnoses may help identify women at risk of postpartum suicide attempt.

Key words: attempted suicide, hospitalization, postpartum, pregnancy, psychiatric diagnosis, substance abuse