Department of Health Administration and Policy, George Mason University, 4400 University Drive, MS 5B7, VA, 22030-4444, Fairfax, USA.
Department of Global and Community Health, George Mason University, 4400 University Dr., Fairfax, VA, 22030, USA.
Arch Womens Ment Health. 2021 Jun;24(3):473-481. doi: 10.1007/s00737-020-01089-x. Epub 2020 Nov 21.
Suicidal behaviors during pregnancy are prevalent and have the potential to adversely affect a woman's health and her developing infant. The purpose of this study was to examine prevalence and correlates of suicidal behaviors in a national sample of pregnant women. Using data from the 2009-2018 National Survey on Drug Use and Health, a sample of 7479 pregnant women was analyzed. Multiple logistic regression was used to examine associations between sample characteristics and suicidal behaviors overall and by pregnancy trimester. In this sample, 3.4% of women exhibited suicidal behaviors such as ideation, planning, and attempt. Suicidal behaviors were more prevalent at 4.4% among women in the first trimester compared to the second/third trimesters (2.9%). Of those exhibiting suicidal behavior, 63.0% were ideators, 18.9% planned suicide, and 18.1% attempted suicide. Logistic regression analyses revealed that all racial/ethnic groups of women in the third trimester were less likely to be suicidal relative to black non-Hispanic women. Alcohol abuse (OR 3.70, 95% CI 1.97, 6.81) and major depressive episode (OR 4.91, 95% CI 3.10, 7.84) in the past year significantly increased the odds of suicidality for all pregnant women. Perceived unmet need for treatment increased the likelihood (OR 5.64, 95% CI 3.55, 8.97) of suicidal behavior regardless of trimester. These findings underscore the importance of screening for suicidal behaviors in the first trimester, especially among those with existing mood disorders and substance abuse. Racial/ethnic differences should be considered in targeted interventions for suicide prevention.
怀孕期间的自杀行为较为普遍，有可能对女性健康及其发育中的婴儿产生不利影响。本研究旨在调查全国孕妇样本中自杀行为的流行情况及其相关因素。本研究使用了 2009-2018 年全国毒品使用与健康调查的数据，分析了 7479 名孕妇样本。采用多变量逻辑回归分析方法，研究了样本特征与总体自杀行为以及不同孕期自杀行为之间的关系。在该样本中，有 3.4%的女性表现出自杀意念、计划和尝试等自杀行为。与第二/第三孕期（2.9%）相比，第一孕期女性自杀行为更为常见（4.4%）。在表现出自杀行为的女性中，有 63.0%为有自杀意念者，18.9%计划自杀，18.1%尝试自杀。逻辑回归分析显示，与非裔美国女性相比，所有第三孕期的种族/族裔女性群体发生自杀行为的可能性均较低。过去一年中存在酒精滥用（比值比[OR] 3.70，95%置信区间[CI] 1.97-6.81）和重度抑郁发作（OR 4.91，95% CI 3.10-7.84）会显著增加所有孕妇发生自杀意念的可能性。过去一年中治疗需求未得到满足（OR 5.64，95% CI 3.55-8.97）会增加自杀行为的可能性，而与孕期无关。这些发现突出表明，在第一孕期，特别是在那些存在情绪障碍和物质滥用的孕妇中，应筛查自杀行为。在预防自杀的针对性干预中应考虑种族/族裔差异。
