Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
Acta Psychiatr Scand. 2021 Mar;143(3):206-215. doi: 10.1111/acps.13240. Epub 2020 Oct 19.
To determine whether parenthood among 25- to 44-year-olds is associated with a lower suicide rate in men and women in Sweden, and whether this is explained by selection into parenthood.
In total, 1,582,360 Swedish women and men, born between 1967 and 1985, and childless at their 25 birthday, were followed from 1992 to 2011. All data originated from linkage to national Swedish registers. Cox regression models were used with time-varying parenthood status to estimate adjusted hazard ratios and 95% confidence intervals (aHR;CI) for suicide.
Having one, two, three or more children was associated with 64%, 79% and 78% lower suicide rate, respectively, compared with having no children, in models with basic adjustments. When a wide range of indicators of selection into parenthood were taken into account, the suicide rate was 58% lower in parents with one child and 70% lower in parents with two or more children compared with childless individuals (aHR 0.42 [95% CI 0.36-0.48]; 0.30 [95% CI 0.25-0.35]; 0.30 [95% CI 0.21-0.42]). In fathers with one, two, three or more children suicide rate was 54%, 64% and 59% lower, respectively, compared with non-fathers whereas in mothers was 70%, 83% and 93% lower, respectively, compared with non-mothers.
Parenthood among 25-to 44-year-olds is associated with a lower suicide risk in both men and women but to a larger extent among women, and particularly in parents with two or more children. Although selection into parenthood is possible, a protective effect of parenthood on suicide is likely in both men and women.
在瑞典,确定 25 至 44 岁人群成为父母是否与男性和女性自杀率降低有关,以及这种情况是否可以通过选择生育来解释。
总共随访了 1967 年至 1985 年间出生且 25 岁生日时无子女的 1582360 名瑞典女性和男性,随访时间从 1992 年到 2011 年。所有数据均源自与全国瑞典登记册的链接。使用时变父母身份的 Cox 回归模型来估计自杀的调整后危害比和 95%置信区间(aHR;CI)。
与无子女的人群相比,模型基本调整后,有一个、两个、三个或更多孩子的人群自杀率分别降低了 64%、79%和 78%。当考虑到进入父母身份的广泛选择指标时,与无子女的个体相比,有一个孩子的父母自杀率降低了 58%,有两个或更多孩子的父母自杀率降低了 70%(aHR 0.42[95%CI 0.36-0.48];0.30[95%CI 0.25-0.35];0.30[95%CI 0.21-0.42])。有一个、两个、三个或更多孩子的父亲自杀率分别降低了 54%、64%和 59%,而非父亲的自杀率降低了 70%、83%和 93%。
25 至 44 岁人群成为父母与男性和女性自杀风险降低有关,但女性更为显著,尤其是有两个或更多孩子的父母。尽管生育选择是可能的,但生育对自杀的保护作用可能在男性和女性中都存在。