J. Jo Kim|Laura M. La Porte|Mary P. Saleh|Samantha Allweiss|Marci Adams|Ying Zhou|Richard K. Silver
Suicide Risk Among Perinatal Women Who Report Thoughts of Self-Harm on Depression Screens
NorthShore University HealthSystem|University of Chicago|NorthShore University HealthSystem|University of Chicago|NorthShore University HealthSystem|University of Chicago|NorthShore University HealthSystem|University of Chicago|NorthShore University HealthSystem|University of Chicago|NorthShore University HealthSystem|University of Chicago|NorthShore University HealthSystem|University of Chicago
brief objective estimate incidence clinical significance suicidal ideation revealed perinatal depression screening estimate associated suicide risk methods retrospective cohort study women completing edinburgh postnatal depression scale 2428 weeks gestation 6 weeks postpartum suburban integrated health system approximately 5000 annual deliveries two hospital campuses suicidal ideation edinburgh postnatal depression scale prediction suicide risk examined multivariable modeling qualitative analysis clinical assessments results among 22118 edinburgh postnatal depression scale questionnaires studied suicidal ideation reported 842 38 95 confidence interval ci 3541 positively associated younger maternal age antepartum mean age 309 compared 319 years p001 unpartnered relationship status antepartum 295 compared 165 p001 postpartum 250 compared 175 p01 noncaucasian race antepartum 621 compared 438 p001 postpartum 624 compared 452 p001 nonenglish language antepartum 110 compared 66 p001 postpartum 124 compared 77 p01 public insurance antepartum 199 compared 125 p001 postpartum 182 compared 142 p001 preexisting psychiatric diagnosis antepartum 84 compared 42 p001 postpartum 120 compared 58 p001 multivariable antepartum postpartum models retained relationship status language relationship status language interaction race postpartum model also found planned cesarean delivery negatively associated suicidal ideation risk odds ratio 056 95 ci 036087 severe vaginal laceration positively associated suicidal ideation risk 21 95 ci 100440 qualitative study 574 women reporting suicidal ideation indicated 330 575 95 ci 535615 experienced degree suicidal thought six patients 11 95 ci 0219 demonstrated active suicidal ideation plan intent access means within highest risk group three patients reported suicide attempt within perinatal period conclusion among perinatal women screened depression 38 reported suicidal ideation 11 subgroup high risk suicide findings support need systematic evaluation report suicidal ideation identify small subset requiring urgent evaluation care level evidence ii perinatal women screened depression 38 report suicidal ideation receive protocoldriven evaluation assess acuity