title: Suicidal behavior in pregnant teenagers in southern Brazil: social, obstetric and psychiatric correlates.
abstract: BACKGROUND
  Suicidal behavior and its correlates remain relatively understudied in pregnant teenagers.
  
  
  METHODS
  A cross-sectional study with a consecutive sample of pregnant teenagers recipient of prenatal medical assistance by the national public health system in the urban area of Pelotas, southern Brazil. Sample size was estimated in 871 participants. Suicidal behavior and psychiatric disorders were assessed with the Mini International Neuropsychiatric Interview; the Abuse Assessment Screen was used to identify physical or sexual abuse; social support was assessed with the Medical Outcomes Survey Social Support Scale; a self-report questionnaire was used to collect socio-demographic, obstetric and other psychosocial data.
  
  
  RESULTS
  Forty three (4.94%) teenagers refused to participate, resulting in 828 participants. Prevalence of suicidal behavior was 13.3%; lifetime suicide attempts were referred by 7.4%, with 1.3% reporting attempting suicide within the last month. After adjustment, we found significant associations of suicidal behavior with the 18-19 years old subgroup, low education, prior abortion, previous major depression, and physical abuse within the last 12 months. Pregnant teenagers with high social support showed prevalence ratios (PR) 67% lower (PR: 0.33; 95%CI: 0.19-0.56) than those with low social support. Furthermore, a wide range of psychiatric disorders, most notably major depressive disorder (PR: 2.75; 95%CI: 1.34-5.63) and panic disorder (PR: 6.36; 95%CI: 1.61-25.10), remained associated with suicidal behavior after adjustment.
  
  
  CONCLUSIONS
  The cross-sectional design precludes causal inferences.
  
  
  CONCLUSIONS
  We found that suicidal behavior is a relatively common feature in pregnant teenagers, frequently associated with psychiatric disorders.
authors: Programa de Pós-Graduação em Saúde & Comportamento, Centro de Ciências da Vida e da Saúde, Universidade Católica de Pelotas, Brazil. ricardop@terra.com.br
authors: Ricardo Tavares
authors: RT
authors: Pinheiro
authors: Fábio Monteiro
authors: FM
authors: da Cunha Coelho
authors: Ricardo Azevedo
authors: RA
authors: da Silva
authors: Luciana
authors: L
authors: de Ávila Quevedo
authors: Luciano Dias
authors: LD
authors: de Mattos Souza
authors: Rochele Dias
authors: RD
authors: Castelli
authors: Mariana Bonati
authors: MB
authors: de Matos
authors: Karen Amaral Tavares
authors: KA
authors: Pinheiro
mesh_terms: D000293:Adolescent; D001938:Brazil / Q000453:epidemiology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D016584:Panic Disorder / Q000453:epidemiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000523:psychology; D015995:Prevalence; D012307:Risk Factors; D012944:Social Support; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000523:psychology / Q000706:statistics & numerical data*; D014505:Urban Population; D055815:Young Adult