Characteristics of suicidal attacks in pregnancy; a multicenter study

Area of Science:

• Obstetrics and Gynecology
• Public Health
• Psychiatry

Background:

• Suicide attempts (SA) during pregnancy pose a significant public health concern, encompassing maternal and fetal mortality risks.
• Understanding regional variations in SA methods, gestational week distribution, and common drug choices is vital for targeted prevention.
• Pregnancy-associated SA necessitates specialized attention due to combined maternal-fetal health implications.

Purpose of the Study:

• To investigate the characteristics and outcomes of suicide attempts in pregnant women admitted to emergency departments.
• To identify risk factors and common methods associated with SA in pregnancy.
• To inform preventive strategies and improve maternal-fetal health outcomes.

Main Methods:

• Retrospective analysis of pregnant women admitted for SA to three university hospital emergency departments (2015-2020).
• Data collection included SA features, demographic variables (age, gravidity, gestational week), and pregnancy outcomes.
• Analysis of obstetric and non-obstetric injuries.

Main Results:

• A total of 78 pregnant women were analyzed, with a mean age of 26.9 years.
• SA occurred most frequently in the first trimester (42.3%) and least in the third trimester (20.5%).
• High-dose drug intake (89.7%) was the predominant method, with paracetamol, iron/folic acid, and antidepressants being common choices.

Conclusions:

• Pregnant women are vulnerable to SA, especially in the first trimester, with 75% lacking prior psychiatric diagnoses.
• Routine psychiatric evaluation during pregnancy, particularly in the first trimester, is recommended for early detection of risk factors.
• Awareness of high-dose treatment protocols for common drugs like paracetamol is crucial for emergency physicians and obstetricians to improve maternal-fetal outcomes.