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Background Pregnancy is a period when women are particularly vulnerable to suicidal ideation and a great opportunity for suicide risk prevention. Aims This study aimed to establish a comprehensive understanding of suicidal ideation prevalence, risk factors, screening tools, consequences and management during pregnancy. Method A literature search was performed in MEDLINE and PsycInfo databases from 2016 to 2021. A narrative synthesis of the literature and a critical overview of the current issues/questions to be addressed within the topic of suicidal ideation during pregnancy was performed. Results The prevalence of suicidal ideation during pregnancy was between 2.73 and 18% internationally. The risk factors identified were major depressive disorder, anxiety disorder, difficulties with sleep, previous suicide attempts, high rumination, low incomes, being black, being young, low educational level, partner violence, having poor support, food insecurity, history of child abuse, high obstetric risk, multiparity, previous induced abortion and exposure to tobacco or human immunodeficiency virus diagnosis. The screening tools used for suicidal ideation during pregnancy were item 10 of the Edinburgh Postpartum Depression Scale and item 9 of the Patient Health Questionnaire. Results showed that suicidal ideation during pregnancy is associated with poor cognitive development in children and low birth weight. No case management studies on suicidal ideation were found. Limitations The main limitation of the available studies was the lack of articles with a high degree of methodological rigour on this subject. Conclusions This narrative review is a state-of-the-art paper about suicidal ideation during pregnancy. Further research is needed, and researchers should carry out systematic reviews and meta-analyses, leading to Clinical Practice Guidelines in this area. This effort would improve our evidence-based practice in Perinatal Psychology and prevent associated suicidal behaviour.

Introducción: La maternidad es un momento en la vida de las mujeres en el que se necesita especialmente el apoyo del entorno social para mitigar las demandas que requieren el periodo de gestación y el posparto inmediato. Método: En este estudio multicéntrico, la muestra incluye 1524 mujeres embarazadas reclutadas del área obstétrica de dos hospitales españoles de tercer nivel asistencial. Se comparan las respuestas de las mujeres que dicen presentar ideación suicida con aquellas que informan no presentarla, analizando sus respuestas al ítem 9 del Patient Health Questionnaire (PHQ-9) y se comparan las diferencias en las distintas dimensiones del PHQ-9 (cognitivo-afectiva, somática y puerperal). Se analiza qué componentes del apoyo social percibido funcionaban como factores predictores de la ideación suicida prenatal, mediante el análisis de sus respuestas en el Postpartum Depression Predictors Inventory (PDPI-R). Resultados: Las mujeres con ideación suicida tienen mayor carga cognitiva-afectiva, somática y puerperal, frente a las que no presentan ideación suicida. La falta de apoyo emocional percibido de la pareja o las amistades y la falta de apoyo práctico percibido de la familia son factores que predicen la ideación suicida. Discusión: Es importante proporcionar a las mujeres con apoyo social efectivo para prevenir la ideación suicida.