Factors Associated with Suicide Mortality Among Childbearing-Aged Individuals: A Case-Control Study

Purpose: Examine pregnancy-related, demographic, psychosocial and healthcare utilization factors among childbearing-aged individuals who were pregnant, postpartum or who experienced pregnancy loss Methods: Data from nine health care systems in the Mental Health Research Network was included in this sample. A case-control study design was used in which 290 childbearing-age individuals who died by suicide (cases) from 2000-2015 were matched with 10 childbearing-age individuals from the same healthcare system and enrolled during the same time period who did not die by suicide (n=2,900). Conditional logistic regression was used to analyze associations between pregnancy/postpartum/pregnancy loss status and suicide. Results: Participants in the sample who died by suicide were more likely to have mental health or substance use disorders (aOR=2.68, 95%CI: 1.69, 4.26), and more likely to have visited the emergency department in the year prior to index date (date of suicide death) (aOR=3.50, 95%CI: 2.50, 4.83). Pregnancy (aOR=0.14, 95% CI: 0.03, 0.63) and delivery status (aOR=0.38, 95% CI: 0.16, 0.87) within a year before the index date was associated with lower risk of suicide. Although a higher percentage of those who experienced perinatal loss died by suicide (aOR=1.43, 95% CI: 0.51, 4.00), this was not statistically significant potentially due to the small sample size (n=6 cases; n=21 control). Conclusions: Although pregnancy and delivery may be protective against suicide, perinatal loss may confer higher risk of suicide. Individuals with anxiety, depression, substance use disorders and prior emergency department encounters who experience pregnancy loss may benefit from routine screening and monitoring for suicide risk