Shigemi Daisuke, Ishimaru Miho, Matsui Hiroki, Fushimi Kiyohide, Yasunaga Hideo
Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan.
Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan.
J Psychiatr Res. 2021 Jan;133:101-105. doi: 10.1016/j.jpsychires.2020.12.024. Epub 2020 Dec 11.
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.
孕期自杀未遂的母婴结局鲜有研究。我们调查了自杀未遂的住院孕妇的临床特征（产妇年龄、孕周、精神神经合并症、自杀未遂方法）和围产期关键结局。本研究是一项全国性回顾性队列研究，使用日本急性护理住院患者的全国数据库——诊断程序组合数据库。我们确定了2016年1月至2018年3月期间因自杀未遂入住参与研究医院的所有孕妇。主要复合结局定义为围产期关键结局，包括以下任何一种：人工流产或自然流产、死胎和孕产妇死亡。共有319例符合条件的患者，其中126例（39.5%）入院时患有精神和行为障碍。与采用非暴力自杀方法的女性相比，采用暴力自杀方法的女性更有可能接受母亲输血、发生死胎和孕产妇死亡。多变量逻辑回归分析显示，暴力自杀方法（比值比=3.57[95%置信区间=1.15-11.1]）与围产期关键结局显著相关。医疗保健提供者应关注孕妇的心理健康，无论其是否患有精神和行为障碍并发症。暴力自杀方法与围产期关键结局之间存在关联这一发现可能对医疗保健提供者有所帮助。
