title: Suicidality among pregnant women in Brazil: prevalence and risk factors.
abstract: Suicide is one of the major causes of preventable death. We evaluated suicidality among pregnant women who participated in prenatal care in Brazil. A total of 255 patients were assessed using semi-structured interviews as well as the Edinburgh Postnatal Depression Scale (EPDS), Beck Depression Inventory (BDI), and Mini-International Neuropsychiatric Interview (MINI) Plus. Thereafter, Stata 12 was used to identify the significant predictors of current suicide risk (CSR) among participants using univariate and multivariate analyses (p < 0.05). According to MINI Plus module C, the lifetime suicide attempt rate was 12.55%. The overall CSR was 23.53%, distributed across risk levels of low (12.55%), moderate (1.18%), and high (9.80%). Our rates approximate those found in another Brazilian study (18.4%). Antenatal depression (AD), lifetime bipolar disorder, and any current anxiety disorder (as measured using the MINI) as well as BDI scores ≥15 and EPDS scores ≥11 were identified as positive risk factors in a univariate analysis (p < 0.001). These factors changed after a multivariate analysis was employed, and only years of education [odds ratio (OR) = 0.45; 95% confidence intervals (CIs) = 0.21-0.99], AD (OR = 3.42; 95% CIs = 1.37-8.53), and EPDS scores ≥11 (OR = 4.44; 95% CIs = 1.97-9.97) remained independent risk factors. AD and other psychiatric disorders were the primary risk factors for suicidality, although only the former remained an independent factor after a multivariate analysis. More than 10 years of education and EPDS scores ≥11 were also independent factors; the latter can be used as a screening tool for suicide risk.
authors.affiliation: Postgraduation Program in Molecular Medicine, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil. tiagocastrocouto@gmail.com.|Department of Mental Health, School of Medicine, Universidade Federal de Minas Gerais, Alfredo Balena Av, 190/240 Santa Efigênia, 30130100, Belo Horizonte, MG, Brazil. tiagocastrocouto@gmail.com.
authors.forename: Tiago
authors.initials: T
authors.lastname: Castro e Couto
authors.affiliation: Postgraduation Program in Molecular Medicine, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
authors.forename: Mayra Yara Martins
authors.initials: MY
authors.lastname: Brancaglion
authors.affiliation: Postgraduation Program in Molecular Medicine, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
authors.forename: Mauro Nogueira
authors.initials: MN
authors.lastname: Cardoso
authors.affiliation: Postgraduation Program in Molecular Medicine, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
authors.forename: Gustavo Coutinho
authors.initials: GC
authors.lastname: Faria
authors.affiliation: Postgraduation Program in Molecular Medicine, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.|Department of Mental Health, School of Medicine, Universidade Federal de Minas Gerais, Alfredo Balena Av, 190/240 Santa Efigênia, 30130100, Belo Horizonte, MG, Brazil.|National Institute of Science and Technology-Molecular Medicine (INCT-MM), School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
authors.forename: Frederico Duarte
authors.initials: FD
authors.lastname: Garcia
authors.affiliation: Postgraduation Program in Molecular Medicine, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.|Department of Mental Health, School of Medicine, Universidade Federal de Minas Gerais, Alfredo Balena Av, 190/240 Santa Efigênia, 30130100, Belo Horizonte, MG, Brazil.|National Institute of Science and Technology-Molecular Medicine (INCT-MM), School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Nicolato
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
authors.forename: Regina Amélia Lopes P
authors.initials: RA
authors.lastname: Aguiar
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
authors.forename: Henrique Vitor
authors.initials: HV
authors.lastname: Leite
authors.affiliation: Postgraduation Program in Molecular Medicine, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.|Department of Mental Health, School of Medicine, Universidade Federal de Minas Gerais, Alfredo Balena Av, 190/240 Santa Efigênia, 30130100, Belo Horizonte, MG, Brazil.|National Institute of Science and Technology-Molecular Medicine (INCT-MM), School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
authors.forename: Humberto
authors.initials: H
authors.lastname: Corrêa
mesh_terms: D000293:Adolescent; D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D001938:Brazil / Q000453:epidemiology; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D008875:Middle Aged; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011262:Pregnancy Trimester, Second; D037841:Pregnant People / Q000523:psychology*; D011296:Prenatal Diagnosis; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D013405:Suicide / Q000523:psychology* / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Antenatal depression; Pregnancy; Prenatal screening; Risk factors; Suicidality