Zhong Qiu-Yue, Gelaye Bizu, Miller Matthew, Fricchione Gregory L, Cai Tianxi, Johnson Paula A, Henderson David C, Williams Michelle A
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA.
Department of Health Sciences, Northeastern University, Boston, Massachusetts, USA.
Arch Womens Ment Health. 2016 Jun;19(3):463-72. doi: 10.1007/s00737-015-0597-x. Epub 2015 Dec 18.
Suicide is one of the leading causes of maternal mortality in many countries, but little is known about the epidemiology of suicide and suicidal behavior among pregnant women in the USA. We sought to examine trends and provide nationally representative estimates for suicidal behavior (including suicidal ideation and suicide and self-inflicted injury) among pregnant women from 2006 to 2012 in the USA. Pregnant women aged 12-55 years were identified through pregnancy- and delivery-related hospitalization records from the National (Nationwide) Inpatient Sample. Suicidal behavior was identified by the International Classification of Diseases, Ninth Revision, Clinical Modification codes. Annual, nationwide estimates and trends were determined using discharge and hospital weights. The prevalence of suicidal ideation more than doubled from 2006 to 2012 (47.5 to 115.0 per 100,000 pregnancy- and delivery-related hospitalizations), whereas the prevalence of suicide and self-inflicted injury remained stable. Nearly 10 % of suicidal behavior occurred in the 12-18-year group, showing the highest prevalence per 100,000 pregnancy- and delivery-related hospitalizations (158.8 in 2006 and 308.7 in 2012) over the study period. For suicidal ideation, blacks had higher prevalence than whites; women in the lowest income quartile had the highest prevalence. Although the prevalence of suicidal behavior was higher among hospitalizations with depression diagnoses, more than 30 % of hospitalizations were for suicidal behavior without depression diagnoses. Our findings highlight the increasing burden and racial differences in suicidal ideation among US pregnant women. Targeted suicide prevention efforts are needed for high-risk pregnant women including teens, blacks, and low-income women.
自杀是许多国家孕产妇死亡的主要原因之一，但在美国，关于孕妇自杀及自杀行为的流行病学情况却知之甚少。我们试图研究2006年至2012年美国孕妇自杀行为（包括自杀意念、自杀及自我伤害）的趋势，并提供具有全国代表性的估计数据。通过国家（全国性）住院患者样本中与妊娠和分娩相关的住院记录，确定年龄在12 - 55岁的孕妇。自杀行为通过《国际疾病分类》第九版临床修订本代码来确定。使用出院数据和医院权重确定年度全国估计数据和趋势。从2006年到2012年，自杀意念的患病率增加了一倍多（每10万例与妊娠和分娩相关的住院病例中，从47.5例增至115.0例），而自杀及自我伤害的患病率保持稳定。近10%的自杀行为发生在12 - 18岁年龄组，在研究期间，该年龄组每10万例与妊娠和分娩相关的住院病例中的患病率最高（2006年为158.8例，2012年为308.7例）。对于自杀意念，黑人的患病率高于白人；收入最低四分位数的女性患病率最高。尽管在诊断为抑郁症的住院病例中，自杀行为的患病率较高，但超过30%的住院病例是没有抑郁症诊断的自杀行为。我们的研究结果凸显了美国孕妇自杀意念负担的增加以及种族差异。需要针对包括青少年、黑人及低收入女性在内的高危孕妇开展有针对性的自杀预防工作。
