Bodnar-Deren Susan, Klipstein Kimberly, Fersh Madeleine, Shemesh Eyal, Howell Elizabeth A
1 Department of Sociology and Institute of Women's Health, Virginia Commonwealth University , Richmond, Virginia.
2 Department of Psychiatry, Icahn School of Medicine at Mount Sinai , New York, New York.
J Womens Health (Larchmt). 2016 Dec;25(12):1219-1224. doi: 10.1089/jwh.2015.5346. Epub 2016 May 26.
To examine the association between suicidal ideation (SI), 3 weeks, 3 months, and 6 months postpartum with demographic, psychosocial, clinical factors, and depressive/anxiety symptoms (measured 24-48 hours after delivery), among a cohort of postpartum women.
This study included 1,073 mothers who gave birth in a large tertiary New York City hospital (2009-2010). Later, self-report SI was assessed using the suicide measure from the Edinburgh Postnatal Depression Scale and from the Patient Health Questionnaire.
Two percent of participants presented with SI during the first 6 months postpartum. In bivariate analyses, race/ethnicity, nativity, insurance, and language were significantly correlated with SI 3 weeks, 3 months, and 6 months postpartum. Screening positive for depression (p = 0.0245) and anxiety (0.0454), assessed 1-2 days postpartum, was significantly correlated with later SI in bivariate analyses, as were antepartum complications (p = 0.001), depressive history (0.001), and self-efficacy (0.045). In adjusted models, antepartum complications (OR = 4.681, 95% CI = 1.99-10.99) and depressive history (OR-3.780, 95% CI = 1.514-9.441) were significantly associated with later postpartum SI. Heightened self-efficacy reduced the odds of later SI (p = 0.050).
Findings suggest that SI among a relatively healthy group of new mothers occurs with some frequency. Mothers with a history of depression and antepartum complications may be at increased risk.
在一组产后女性队列中,研究产后3周、3个月和6个月时自杀意念(SI)与人口统计学、心理社会、临床因素以及抑郁/焦虑症状(分娩后24 - 48小时测量)之间的关联。
本研究纳入了在纽约市一家大型三级医院分娩的1073名母亲(2009 - 2010年)。随后,使用爱丁堡产后抑郁量表和患者健康问卷中的自杀测量指标对自我报告的自杀意念进行评估。
2%的参与者在产后前6个月出现自杀意念。在双变量分析中,种族/民族、出生地、保险和语言与产后3周、3个月和6个月时的自杀意念显著相关。产后1 - 2天评估的抑郁筛查阳性(p = 0.0245)和焦虑筛查阳性(0.0454)在双变量分析中与后期自杀意念显著相关,产前并发症(p = 0.001)、抑郁病史(0.001)和自我效能感(0.045)也与后期自杀意念显著相关。在调整模型中,产前并发症(OR = 4.681,95%CI = 1.99 - 10.99)和抑郁病史(OR = 3.780,95%CI = 1.514 - 9.441)与后期产后自杀意念显著相关。自我效能感增强降低了后期自杀意念的几率(p = 0.050)。
研究结果表明,在相对健康的新妈妈群体中,自杀意念有一定频率出现。有抑郁病史和产前并发症的母亲可能风险增加。