TITLE:
Understanding Suicide in Pregnant and Postpartum Women, Using the National Violent Death Reporting System Data: Are There Differences in Rural and Urban Status?
AUTHORS:
Akosua Adu, Sabrina V. Brown, Ibitola Asaolu, Wayne Sanderson
KEYWORDS:
Suicide, Rural, Urban, Pregnant, Non-Pregnant, Postpartum
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.9 No.5,
May
8,
2019
ABSTRACT: Background: Suicide rates in the United States have increased by 30% since 1999 and
suicide is currently the 10th leading cause of death. Suicide has
also become one of the leading causes of death in pregnant and postpartum
women. The aim of this study is to examine whether rurality affects the risk of
suicide in pregnant and postpartum women. Methods: This study used data
from the National Violent Death Reporting System, Restricted Access Dataset
(2003-2012). Bivariate and multivariate analyses were used to first describe
the pregnant and postpartum population versus non-pregnant females (ages 15 - 54),
who all died by suicide, and then to examine urban-rural differences. Results: Rural suicide decedents were much older, married, less likely to have had a
mental health diagnosis, and more likely to use a firearm. Recent intimate
partner crisis and intimate partner problems were both associated with
increased odds that the suicide decedent was pregnant or postpartum in both
urban and rural counties, whereas presence of job problems and report of
history of suicide attempt decreased the odds that the suicide decedent was
pregnant or postpartum in both urban and rural counties. Multivariable
polytomous logistic regression analyses revealed differences in suicide risk factors
among pregnant, postpartum and non-pregnant decedents when stratified by rural
and urban status. Conclusion: Our findings suggest that pregnant and
postpartum women should be screened for risk of suicide, in the clinical
setting, especially if there are intimate partner problems or a crisis. With
proper identification and response, suicide in pregnant and postpartum women
might be decreased.