Adverse perinatal outcomes and risk for postpartum suicide attempt in Washington state, 1987-2001.
OBJECTIVE
Postpartum suicide attempts are serious events with a significant impact on women and their families. Our objectives were to determine the temporal risk period for these events and to assess whether maternal complications and adverse infant outcomes are associated with risk for postpartum suicide attempt.


METHODS
We performed a case-control study that compared 520 women who were hospitalized for a postpartum suicide attempt with 2204 control women who were not hospitalized for a postpartum suicide attempt in Washington State from 1987 to 2001. We performed logistic regression to evaluate whether maternal complications and adverse infant outcome, after controlling for other risk factors, were associated with a hospitalization for a suicide attempt within 1 year after delivery.


RESULTS
Most attempts were the result of poisoning (63.6%). Suicide attempts were most frequent in the first and 12th months after delivery. Maternal complications including labor and delivery complications and cesarean delivery were not associated with risk for postpartum suicide attempt. After adjustment for age and marital status, fetal or infant death was associated with postpartum suicide attempt. Other adverse infant outcomes, including preterm delivery, low birth weight, and congenital malformations, were not associated with attempts.


CONCLUSIONS
Maternal complications were not associated with hospitalizations for suicide attempts in the year after delivery. However, fetal death or the death of an infant in the first year after delivery was strongly associated with hospitalization for a suicide attempt. These risk factors may be useful predictors for health care providers who care for women or children during the postpartum period.
Schiff
Melissa A
MA
Harborview Injury Prevention and Research Center, University of Washington, Seattle, Washington 98104, USA. mschiff@u.washington.edu
Grossman
David C
DC
D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D005260:Female; D005313:Fetal Death; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data; D049590:Postpartum Period / Q000523:psychology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000523:psychology; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D012307:Risk Factors; D013406:Suicide, Attempted / Q000523:psychology* / Q000706:statistics & numerical data*; D014861:Washington / Q000453:epidemiology