Do stillbirth, miscarriage, and termination of pregnancy increase risks of attempted and completed suicide within a year? A population-based nested case–control study
Journal
BJOG: An International Journal of Obstetrics and Gynaecology
Journal Volume
125
Journal Issue
8
Pages
983-990
Date Issued
2018
Author(s)
Abstract
Objective: To investigate the risks of attempted and completed suicide in women who experienced a stillbirth, miscarriage, or termination of pregnancy within 1 year postnatally and compare this risk with that in women who experienced a live birth. Design: A nested case–control study. Setting: Linking three nationwide population-based data sets in Taiwan: the National Health Insurance Research Database, the National Birth Registry and the National Death Registry. Sample: In all, 485 and 350 cases of attempted and completed suicide, respectively, were identified during 2001–11; for each case, ten controls were randomly selected and matched to the cases according to the age and year of delivery. Methods: Conditional logistic regression. Main outcome measures: Attempted and completed suicidal statuses were determined. Results: The rates of attempted suicide increased in the women who experienced fetal loss. The risk of completed suicide was higher in women who experienced a stillbirth [adjusted odds ratio (aOR) 5.2; 95% CI 1.77–15.32], miscarriage (aOR 3.81; 95% CI 2.81–5.15), or termination of pregnancy (aOR 3.12; 95% CI 1.77–5.5) than in those who had a live birth. Furthermore, the risk of attempted suicide was significantly higher in women who experienced a miscarriage (aOR 2.1; 95% CI 1.66–2.65) or termination of pregnancy (aOR 2.5; 95% CI 1.63–3.82). In addition to marital and educational statuses, psychological illness increased the risk of suicidal behaviour. Conclusions: The risk of suicide might increase in women who experience fetal loss within 1 year postnatally. Healthcare professionals and family members should enhance their sensitivity to care for possible mental distress, particularly for women who have experienced a stillbirth. Tweetable abstract: Suicide risk increased in women who had a stillbirth, miscarriage, or termination of pregnancy within 1 year postnatally. ? 2017 Royal College of Obstetricians and Gynaecologists
Subjects
Attempted suicide; completed suicide; miscarriage; stillbirth; termination of pregnancy
Other Subjects
adult; Article; case control study; controlled study; educational status; female; fetus wastage; human; major clinical study; marriage; mental disease; obstetric delivery; population research; pregnancy termination; priority journal; risk; spontaneous abortion; stillbirth; suicide; suicide attempt; epidemiology; induced abortion; live birth; odds ratio; pregnancy; psychology; register; risk factor; spontaneous abortion; statistical model; statistics and numerical data; stillbirth; suicide; suicide attempt; Taiwan; Abortion, Induced; Abortion, Spontaneous; Case-Control Studies; Female; Humans; Live Birth; Logistic Models; Odds Ratio; Pregnancy; Registries; Risk Factors; Stillbirth; Suicide; Suicide, Attempted; Taiwan
Type
journal article