Perinatal suicidal ideation and behaviour: psychiatry and adversity

Area of Science:

• Perinatal mental health
• Global public health
• Psychiatry

Background:

• Pregnant women face higher risks of suicidal ideation and behaviors (SIB).
• Research often overlooks contextual risk factors, especially in low- and middle-income countries.
• South African pregnant women in low-resource settings are a vulnerable population.

Purpose of the Study:

• To determine the prevalence of SIB among pregnant women in South Africa.
• To identify associated psychiatric and socio-economic contextual risk factors for SIB.
• To highlight the need for suicide risk assessment independent of depression and anxiety.

Main Methods:

• A cross-sectional study involving 376 pregnant women in low-resource South African communities.
• Data collection included socio-economic, demographic, social support, life events, interpersonal violence, and mental health diagnoses.
• Statistical analyses included univariate, bivariate, and logistic regression.

Main Results:

• The 1-month prevalence of SIB was 18%.
• SIB was linked to major depressive episode and anxiety disorders, but a significant proportion had no such diagnoses.
• Key risk factors included lower socioeconomic status, food insecurity, interpersonal violence, multiparity, and prior suicide attempts.

Conclusions:

• Socio-economic and contextual factors significantly contribute to SIB in pregnant women.
• Suicide risk assessment should be conducted independently of depression and anxiety diagnoses.
• Interventions should address broader social determinants of mental health in perinatal populations.