Women diagnosed with perinatal depression face an increased risk of suicidal behavior, particularly within the first year following diagnosis, according to a study published in JAMA Network Open.
The research, led by Hang Yu, MSc, from the unit of integrative epidemiology at the Institute of Environmental Medicine at Karolinska Institute, Stockholm, addresses a gap in existing literature by examining the risk of suicidal behavior, including attempted and completed suicides, among women with clinically diagnosed perinatal depression.
The nationwide Swedish population-matched cohort study included 86,551 women (mean age, 30.67 years) diagnosed with perinatal depression between 2001 and 2017. Researchers compared this group with 865,510 unaffected women matched by age and calendar year at delivery. Perinatal depression was identified through diagnosis or filled antidepressant prescriptions from pregnancy to 1 year postpartum.
Over a median follow-up of 6.91 years, 3,604 suicidal behavior events occurred among women with perinatal depression, with an incidence rate of 5.62 per 1,000 person-years. In contrast, women without perinatal depression experienced 6,445 suicidal behavior events, with an incidence rate of 1.01 per 1,000 person-years.
The study found that women with perinatal depression had a significantly higher risk for suicidal behavior compared to matched counterparts without perinatal depression (HR = 3.15; 95% CI, 2.97-3.35). This elevated risk persisted when comparing women with perinatal depression to their biological siblings without perinatal depression (HR = 2.75; 95% CI, 2.1-3.61).
Furthermore, the association between perinatal depression and suicidal behavior was more pronounced among women with postnatal depression (HR = 3.55; 95% CI, 3.26-3.86) and those without a history of psychiatric disorders (HR = 3.63; 95% CI, 3.36-3.92).
The study emphasizes the urgency of vigilant clinical monitoring and timely intervention for this vulnerable population to prevent devastating outcomes, regardless of their psychiatric history prior to pregnancy, the researchers concluded.