Published online September 1, 2006
PEDIATRICS Vol. 118 No. 3 September 2006, pp. e669-e675 (doi:10.1542/peds.2006-0116)
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ARTICLE

Adverse Perinatal Outcomes and Risk for Postpartum Suicide Attempt in Washington State, 1987–2001

Melissa A. Schiff, MD, MPHa,b and David C. Grossman, MD, MPHa,c

a Harborview Injury Prevention and Research Center
b Department of Epidemiology, University of Washington, Seattle, Washington
c Center for Health Studies, Group Health Cooperative, Seattle, Washington

OBJECTIVE. Postpartum suicide attempts are serious events with a significant impact on women and their families. Our objectives were to determine the temporal risk period for these events and to assess whether maternal complications and adverse infant outcomes are associated with risk for postpartum suicide attempt.

METHODS. We performed a case-control study that compared 520 women who were hospitalized for a postpartum suicide attempt with 2204 control women who were not hospitalized for a postpartum suicide attempt in Washington State from 1987 to 2001. We performed logistic regression to evaluate whether maternal complications and adverse infant outcome, after controlling for other risk factors, were associated with a hospitalization for a suicide attempt within 1 year after delivery.

RESULTS. Most attempts were the result of poisoning (63.6%). Suicide attempts were most frequent in the first and 12th months after delivery. Maternal complications including labor and delivery complications and cesarean delivery were not associated with risk for postpartum suicide attempt. After adjustment for age and marital status, fetal or infant death was associated with postpartum suicide attempt. Other adverse infant outcomes, including preterm delivery, low birth weight, and congenital malformations, were not associated with attempts.

CONCLUSIONS. Maternal complications were not associated with hospitalizations for suicide attempts in the year after delivery. However, fetal death or the death of an infant in the first year after delivery was strongly associated with hospitalization for a suicide attempt. These risk factors may be useful predictors for health care providers who care for women or children during the postpartum period.

Key Words: injury • postpartum care • suicide • pregnancy

Abbreviations: CHARS—Comprehensive Hospital Abstract Recording System • ICD-9-CM—International Classification of Diseases, Ninth Revision, Clinical Modification

Accepted Mar 8, 2006.


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