Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan.
Department of Obstetrics and Gynecology, Kang Ning Hospital, Taipei 11490, Taiwan.
Int J Environ Res Public Health. 2022 Apr 23;19(9):5118. doi: 10.3390/ijerph19095118.
To examine the association of postpartum depression (PPD) with maternal suicide in the Taiwanese population.
We examined the medical records of women aged 18-50 years who experienced childbirth and had PPD (the study cohort, = 2882), who experienced childbirth but did not have PPD (comparison cohort 1, = 5764), and who neither experienced childbirth nor had PPD (comparison cohort 2, = 5764) between 2000 and 2015. The patients were followed up until suicide, withdrawal from the National Health Insurance program, or 31 December 2015.
The rates of anxiety and depression symptoms, as well as the cumulative risk of suicide, were significantly higher in the study cohort. PPD was significantly correlated with an increased risk of maternal suicide and was associated with a greater risk of developing comorbidities such as hypertension, diabetes mellitus, hyperlipidemia, and stroke. The comparison cohorts did not differ significantly in terms of suicide risk.
PPD was associated with a significantly higher rate of suicide and a shorter time to suicide after childbirth. Younger age, winter, and subclinical depression and anxiety positively predicted suicide in the study cohort. To prevent maternal suicide, clinicians should be observant of subclinical depression and anxiety symptoms among patients.
本研究旨在探讨产后抑郁症(PPD)与台湾地区产妇自杀之间的关联。
我们对 2000 年至 2015 年间分娩且患有 PPD 的 2882 名年龄在 18-50 岁的女性(研究队列)、分娩但未患有 PPD 的 5764 名女性(对照队列 1)和既未分娩也未患有 PPD 的 5764 名女性(对照队列 2)的病历进行了研究。对患者进行随访,直至自杀、退出全民健康保险计划或 2015 年 12 月 31 日。
研究队列中焦虑和抑郁症状的发生率以及自杀的累积风险明显更高。PPD 与产妇自杀风险增加显著相关,且与高血压、糖尿病、高血脂和中风等共病的发生风险增加相关。对照队列在自杀风险方面无显著差异。
PPD 与产后自杀率显著升高和自杀发生时间缩短显著相关。研究队列中,年龄较小、冬季、亚临床抑郁和焦虑与自杀风险呈正相关。为预防产妇自杀,临床医生应关注患者的亚临床抑郁和焦虑症状。