Prevalence and associated factors of suicidal behavior among pregnant mothers in southern Ethiopia: a cross-sectional study

Abstract

Background Suicidal behavior among pregnant mothers is one of the most common psychiatric emergencies that require a major public health concern by researchers and mental health task forces. Pregnant mothers experience suicidal attempt, which is a fatal problem to end life. Therefore, there was a need to assess the prevalence and associated factors of suicidal behavior among pregnant mothers to integrate mental health care, particularly suicide, with maternal management. Methods A cross-sectional study was conducted among 504 pregnant mothers in the Gedeo zone, southern Ethiopia. Suicidal behavior was assessed using revised suicidal behavior questionnaire (SBQ-R) with a total score of 3-18; those scoring ≥7 were considered as having Suicidal behavior. Data were entered into Epi-data 3.1 and analyzed using SPSS version 20. Bivariate and multivariate binary logistic regression analysis was performed to identify associated factors of suicidal behavior. Variables with a P-value less than 0.05 with 95% CI were considered statistically significant. Results In this study, the overall prevalence of suicidal behavior among pregnant mothers was 47(9.3%) with 95% CI (7.1- 11.9). Regarding the factors; being unmarried [AOR = 5.69, 95% CI, (1.19, 27.23)], gestation age greater than 27 weeks, [AOR = 4.92, 95% CI (1.67, 14.53)], history of having chronic medical illness [AOR = 4.47, 95% CI (1.35, 14.85)], depression [AOR = 4.20, 95% CI (1.90, 9.28], and intimate partner violence [AOR = 7.60, 95% CI (3.27, 17.67)] were significantly associated with suicidal behavior at P value less than 0.05 and corresponding 95% CI. Conclusion Pregnant mothers in the community had a high prevalence of suicidal behavior compared to studies conducted among general populations. It is better to include and implement the assessment of suicidal risk factors as a primary treatment package for pregnant mothers, training of health extension workers and other primary health workers on how to assess the risk of suicide among pregnant mothers is warranted.

Women with perinatal suicidal ideation–A scoping review of the biopsychosocial risk factors to inform health service provision and research

“…Participants with chronic medical conditions were 4.47 times more likely to experience suicidal behaviours compared to those without chronic medical conditions [ 50 ]. Biological changes such as inflammation and low levels of serotonin were also found to be associated with suicidal ideation, possibly indicating dysregulated immunity in women with postpartum depression [ 44 ].…”

“…Moreover, women with a history of suicide attempts [ 42 , 54 , 70 , 71 ] anxiety disorders [ 66 , 68 , 70 ], stress [ 47 ], depressive disorders [ 42 , 51 , 54 , 58 , 60 , 61 , 68 , 70 ], bipolar affective disorder [ 65 ] or post-traumatic stress disorder [ 42 ] were at increased risk of suicidal ideation during the perinatal period. Women with a diagnosis of depression were between 2.32 times [ 50 ], 4 times [ 47 ] and 4.40 times [ 49 ] more likely to experience suicidal ideation. Similarly, Belete et al .…”

“…Molla et al . [ 50 ] also reported women who experienced IPV were 7.60 times more likely to experience suicidal behaviour whilst Anbesaw et al . [ 47 ] identified IPV as increasingly the likelihood of experiencing suicidal ideation however, the risk was lower at 2.45 times.…”

“…Of the forty-one studies that met eligibility criteria, twelve were conducted in the USA [34][35][36][37][38][39][40][41][42][43][44][45], five in Ethiopia [46][47][48][49][50], four in South Africa [51][52][53][54], three in Italy [55][56][57], two in China [58,59], two in Japan [60,61], one in Peru [62], one in the UK [63], one in France [64], one in Canada [65], one in Germany [66], one in Spain [67], one in Romania [68], one in Bangladesh [69], one in Pakistan [70], one in India [71], one on the Thailand-Myanmar border [72], one in Tanzania [73] and one in Ireland [74]. In total, 55,439 participants were recruited across the forty-one studies with individual sample sizes ranging from 14 [37] to 22,118 [36].…”

“…In addition, pregnancy and birth complications, birth trauma and infant illness were reported as being associated with suicidal ideation [37,39,46]. Molla et al [50] reported women with a gestational age of greater than 27 weeks were 4.92 times more likely to experience suicidal behaviours, compared to those with a gestational age of less than 14 weeks. This cross-sectional study examined suicidal behaviour in pregnant women to integrate mental healthcare with maternal healthcare [50].…”