Suicidality among pregnant women in Brazil: prevalence and risk factors

Tiago Castro e Couto, Mayra Yara Martins Brancaglion, Mauro Nogueira Cardoso, Gustavo Coutinho Faria, Frederico Duarte Garcia, Rodrigo Nicolato, Regina Amélia Lopes P. Aguiar, Henrique Vitor Leite, Humberto Corrêa

Suicide is one of the major causes of preventable death. We evaluated suicidality among pregnant women who participated in prenatal care in Brazil. A total of 255 patients were assessed using semi-structured interviews as well as the Edinburgh Postnatal Depression Scale (EPDS), Beck Depression Inventory (BDI), and Mini-International Neuropsychiatric Interview (MINI) Plus. Thereafter, Stata 12 was used to identify the significant predictors of current suicide risk (CSR) among participants using univariate and multivariate analyses (p < 0.05). According to MINI Plus module C, the lifetime suicide attempt rate was 12.55 %. The overall CSR was 23.53 %, distributed across risk levels of low (12.55 %), moderate (1.18 %), and high (9.80 %). Our rates approximate those found in another Brazilian study (18.4 %). Antenatal depression (AD), lifetime bipolar disorder, and any current anxiety disorder (as measured using the MINI) as well as BDI scores ≥15 and EPDS scores ≥11 were identified as positive risk factors in a univariate analysis (p < 0.001). These factors changed after a multivariate analysis was employed, and only years of education [odds ratio (OR) = 0.45; 95 % confidence intervals (CIs) = 0.21-0.99], AD (OR = 3.42; 95 % CIs = 1.37-8.53), and EPDS scores ≥11 (OR = 4.44; 95 % CIs = 1.97-9.97) remained independent risk factors. AD and other psychiatric disorders were the primary risk factors for suicidality, although only the former remained an independent factor after a multivariate analysis. More than 10 years of education and EPDS scores ≥11 were also independent factors; the latter can be used as a screening tool for suicide risk.