FEMALES diagnosed with perinatal depression face an increased risk of suicidal behaviour, particularly in the first year following diagnosis, according to research from the Institute of Environmental Medicine at Karolinska Institutet, Stockholm, Sweden. The research, led by Hang Yu, aimed to address a gap in understanding the risk of suicide among females with perinatal depression.
The nationwide Swedish population-matched cohort study involved 86,551 females (mean age: 30.67 years), who were diagnosed with perinatal depression between 2001–2017. Another group of 865,510 unaffected females was matched by age and calendar year at delivery. Perinatal depression was identified through diagnosis or filled antidepressant prescriptions during pregnancy, and up to 1-year postpartum.
Over a median follow-up of 6.91 years, 3,604 suicidal behaviour events occurred among females with perinatal depression, with an incidence rate of 5.62 per 1,000 person-years. In comparison, females without perinatal depression experienced 6,445 suicidal behaviour events, with an incidence rate of 1.01 per 1,000 person-years. Females with perinatal depression had a significantly higher risk for suicidal behaviour compared to matched females without perinatal depression (hazard ratio [HR]: 3.15; 95% confidence interval [CI]: 2.97–3.35). The association remained consistent when comparing females with perinatal depression to their biological siblings without the condition (HR: 2.75; 95% CI: 2.1–3.61).
The study highlighted an even greater association between perinatal depression and suicidal behaviour among females 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 elevated risk of suicidal behaviour was particularly pronounced during the first year after diagnosis (HR: 7.2; 95% CI: 6.07–8.54), remaining statistically significant during 5–18 years of follow-up (HR: 2.34; 95% CI: 2.12–2.57).
Overall, the researchers emphasise the urgent need for vigilant clinical monitoring and prompt intervention for females with perinatal depression, regardless of their pre-pregnancy history of psychiatric disorders, to prevent devastating outcomes.
