Department of Pediatrics and University of California, San Diego (UCSD), La Jolla, California, USA.
Department of Psychiatry, University of California, San Diego (UCSD), La Jolla, California, USA.
J Womens Health (Larchmt). 2023 May;32(5):608-615. doi: 10.1089/jwh.2022.0255. Epub 2023 Mar 3.
The objectives of this study were to describe trends in the prevalence of postpartum suicidal behaviors in California, 2013-2018, and to estimate associations between adverse perinatal outcomes and suicidal behaviors. We used data from a population-based cohort derived from all birth and fetal death certificates. Records were individually linked to maternal hospital discharge records for the years before and after delivery. We estimated the prevalence of postpartum suicidal ideation and attempt by year. Then, we estimated crude and adjusted associations between adverse perinatal outcomes and these suicidal behaviors. The sample included 2,563,288 records. The prevalence of postpartum suicidal ideation and attempt increased from 2013 to 2018. People with postpartum suicidal behavior were younger, had less education, and were more likely to live in rural areas. A greater proportion of those with postpartum suicidal behavior were Black and publicly insured. Severe maternal morbidity, neonatal intensive care unit admission, and fetal death were associated with greater risk of ideation and attempt. Major structural malformation was not associated with either outcome. The burden of postpartum suicidal behavior has increased over time and is unequally distributed across population subgroups. Adverse perinatal outcomes may help identify individuals that could benefit from additional care during the postpartum period.
本研究的目的是描述 2013 年至 2018 年加利福尼亚州产后自杀行为的流行趋势，并估计不良围产期结局与自杀行为之间的关联。我们使用了一项基于人群的队列研究的数据，该研究来自所有的分娩和胎儿死亡证明。记录被单独与产妇分娩前后的住院记录相关联。我们按年份估计产后自杀意念和自杀企图的发生率。然后，我们估计了不良围产期结局与这些自杀行为之间的粗关联和调整关联。样本包括 2563288 条记录。产后自杀意念和自杀企图的发生率从 2013 年到 2018 年呈上升趋势。有产后自杀行为的人更年轻，受教育程度更低，更有可能居住在农村地区。有产后自杀行为的人中有更大比例是黑人，并且有公共保险。严重的产妇发病率、新生儿重症监护病房入院和胎儿死亡与更高的自杀意念和企图风险相关。主要的结构畸形与这两种结果都没有关联。产后自杀行为的负担随着时间的推移而增加，并且在人群亚组中分布不均。不良围产期结局可能有助于识别在产后期间可能受益于额外护理的个体。
