Suicide attempts during pregnancy and perinatal outcomes.

Maternal and fetal outcomes of suicide attempts during pregnancy have rarely been examined. We examined the clinical characteristics (maternal age, gestational age in pregnancy, psychoneurological comorbidities, methods of suicide attempts) and critical perinatal outcomes among hospitalized pregnant women who attempted suicide. The current study was a nationwide retrospective cohort study using the Diagnosis Procedure Combination database, a national database for acute-care inpatients in Japan. We identified all pregnant women who were admitted to participating hospitals because of suicide attempts from January 2016 to March 2018. Main composite outcome was defined as critical perinatal outcomes including any of the following: induced or spontaneous abortion, intrauterine fetal death and maternal death. There were 319 eligible patients, of whom 126 (39.5%) had mental and behavioral disorders on admission. Blood transfusion for mother, intrauterine fetal death, and maternal death were more likely to occur in women with violent methods of suicide attempts than in women with non-violent methods. A multivariable logistic regression analysis showed that violent methods of suicide attempts (OR = 3.57 [95% CI = 1.15-11.1]) were significantly associated with critical perinatal outcomes. Healthcare providers should pay attention to mental health among pregnant women, regardless of complications of mental and behavioral disorders. The finding of associations between violent methods of suicide attempts and critical perinatal outcomes may be helpful for healthcare providers.