Suicidal Ideation During the Postpartum Period

Susan Bodnar-Deren

Kimberly Klipstein

Madeleine Fersh

Eyal Shemesh

Elizabeth Howell

^{Department of Sociology and Institute of Women's Health, Virginia Commonwealth University, Richmond, Virginia.}

^{Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York.}

^{Department of Psychiatry, North Shore LIJ, Zucker Hillside Hospital, Glen Oaks, New York.}

^{Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York.}

^{Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York.}

^{Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York.}

^{Corresponding author.}

Address correspondence to:, Susan Bodnar-Deren, PhD, Department of Sociology and Institute of Women's Health, Virginia Commonwealth University, 827 West Franklin Street, Richmond, VA 23284, E-mail:Email: ude.ucv@randobms

Abstract

Objective: To examine the association between suicidal ideation (SI), 3 weeks, 3 months, and 6 months postpartum with demographic, psychosocial, clinical factors, and depressive/anxiety symptoms (measured 24–48 hours after delivery), among a cohort of postpartum women.

Methods: This study included 1,073 mothers who gave birth in a large tertiary New York City hospital (2009–2010). Later, self-report SI was assessed using the suicide measure from the Edinburgh Postnatal Depression Scale and from the Patient Health Questionnaire.

Results: Two percent of participants presented with SI during the first 6 months postpartum. In bivariate analyses, race/ethnicity, nativity, insurance, and language were significantly correlated with SI 3 weeks, 3 months, and 6 months postpartum. Screening positive for depression (p = 0.0245) and anxiety (0.0454), assessed 1–2 days postpartum, was significantly correlated with later SI in bivariate analyses, as were antepartum complications (p = 0.001), depressive history (0.001), and self-efficacy (0.045). In adjusted models, antepartum complications (OR = 4.681, 95% CI = 1.99–10.99) and depressive history (OR-3.780, 95% CI = 1.514–9.441) were significantly associated with later postpartum SI. Heightened self-efficacy reduced the odds of later SI (p = 0.050).

Conclusion: Findings suggest that SI among a relatively healthy group of new mothers occurs with some frequency. Mothers with a history of depression and antepartum complications may be at increased risk.

Keywords: : postpartum suicide, postpartum suicidal ideation, postpartum depression, maternal mortality, maternal mental health, antepartum complications

Abstract

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