What the research shows
A research team analyzed the records of nearly a million women in Sweden’s national medical registries from 2001 to 2017, comparing 86,551 women with perinatal depression to 865,510 women who did not. The groups were matched according to age and year of delivery.
In two studies, the team found that depression that begins during or shortly after pregnancy can have troubling consequences up to age 18.
A study, published Tuesday in JAMA Network Open, found that women with perinatal depression were three times more likely to experience suicidal behavior, defined as attempting or completing suicide. The risks were highest in the year following their diagnosis, but, although they decreased over time, years later the risks were still twice as high as in women without the disease.
The other study, published Wednesday in BMJ, found that women with perinatal depression were six times more likely to commit suicide than those without this diagnosis. The number of suicides was small, but it accounted for a significant portion of the deaths of women diagnosed with perinatal depression: 149 of the 522 deaths in this group, or 28.5 percent. For women without perinatal depression, there were 117 suicides out of 1,568 deaths, or 7.5 percent.
Suicide was a major reason why women with perinatal depression were twice as likely to die from any cause during the 18-year study period, compared to women without of this disorder.
The researchers also compared more than 20,000 women with perinatal depression to their biological sisters who gave birth during the same period and did not suffer from the disorder. The risk of suicidal behavior for sisters with perinatal depression was nearly three times that of their sisters without a diagnosis – almost as high as the difference between women with the condition and those without it and with whom they were not related. This suggests that depression plays a larger role in these outcomes than genetics or childhood environment, the researchers wrote.
Behind the numbers
The average age at which women experienced perinatal depression was 31 years. They were more likely than those without the disease to live alone, have lower income and less formal education, have recently smoked and have never given birth before, among other characteristics. the researchers reported.
They were also more likely to have previously had psychiatric disorders or suicidal behavior. But studies found that whether or not women had other mental health problems, perinatal depression increased the risk of suicidal behavior and death. This suggests that pregnancy-related depression may be different and more serious than other mental health disorders.
“This highlights the urgent need for vigilant clinical monitoring and rapid intervention for this vulnerable population to avoid such devastating consequences, regardless of the history of psychiatric disorders before pregnancy,” concluded the JAMA Open Network study.
There may be differences in the experiences of women who develop depression during pregnancy – just over half of the women in the study – and those with postpartum depression that emerges within a year. childbirth. Researchers found that women with postpartum depression were at greater risk of suicidal behavior and death, but it was unclear why.
The data did not reveal that pregnancy complications, birth weight, or gestational age of the newborn affected maternal suicidal behavior.
More to learn
Perinatal depression, which is believed to affect 10 to 20 percent women During or shortly after pregnancy, it remains little studied, undertreated and probably underdiagnosed. Some reports suggest that this disorder has become even more common during the coronavirus pandemic due to social isolation and reduced access to care.
Although new studies shed light on the effects of perinatal depression, many questions remain. For example, researchers said they couldn’t capture factors like domestic violence or alcohol use. And the studies may not be representative of other countries’ experiences, since, for example, most women in Swedish registries were white and Sweden is relatively rich in universal health care.
The role of treatment and therapy is not yet fully understood. Studies classified women as having perinatal depression if doctors had diagnosed them or if they had filled prescriptions for antidepressants during pregnancy or a year later, indicating that they had received treatment. For those who do not benefit from any treatment or therapy, the consequences could be amplified.
If you are having suicidal thoughts, call or text 988 to reach the 988 Suicide and Crisis Lifeline or visit SpeakingOfSuicide.com/resources for a list of additional resources. Go here for resources outside the United States.