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Maternal suicide in Italy

  • Ilaria LegaEmail author
  • Alice Maraschini
  • Paola D’Aloja
  • Silvia Andreozzi
  • Daniela Spettoli
  • Manuela Giangreco
  • Monica Vichi
  • Marzia Loghi
  • Serena Donati
  • the Regional maternal mortality working group
Original Article

Abstract

Suicide has been identified as one of the most common causes of death among women within 1 year after the end of pregnancy in several high-income countries. The aim of this study was to provide the first estimate of the maternal suicide ratio and a description of the characteristics of women who died by suicide during pregnancy or within 1 year after giving birth, induced abortion or miscarriage (i.e., maternal suicide) in 10 Italian regions, covering 77% of total national births. Maternal suicides were identified through the linkage between regional death registries and hospital discharge databases. Background population data was collected from the national hospital discharge, abortion and mortality databases. The previous psychiatric history of the women who died by maternal suicide was retrieved from the regionally available data sources. A total of 67 cases of maternal suicide were identified, corresponding to a maternal suicide ratio of 2.30 per 100,000 live births in 2006–2012. The suicide rate was 1.18 per 100,000 after giving birth (n = 2,876,193), 2.77 after an induced abortion (n = 650,549) and 2.90 after a miscarriage (n = 379,583). The majority of the women who died by maternal suicide (34/57) had a previous psychiatric history; 15/18 previously diagnosed mental disorders were not registered along with the index pregnancy obstetric records. Suicide is a relevant cause of maternal death in Italy. The continuity of care between primary, mental health and maternity care were found to be critical. Clinicians should be aware of the issue, as they may play an important role in preventing suicide in their patients.

Keywords

Suicide Maternal mortality Pregnancy Abortion Postpartum 

Notes

Acknowledgements

This research was supported by the Italian Ministry of Health.

We thank Laura Lauria for assistance with methodology, Marina Pediconi for her valuable technical assistance, Gianpaolo Coscia and Claudia Ferraro for the English language revision. We are grateful to Emanuele Caroppo (MD PhD, Università Cattolica del Sacro Cuore, Rome) for comments that greatly improved the manuscript.

The authors thank the Italian Ministry of Health and the National Institute of Statistics (ISTAT) for sharing the national data files.

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2019

Authors and Affiliations

  • Ilaria Lega
    • 1
    Email author
  • Alice Maraschini
    • 1
  • Paola D’Aloja
    • 1
  • Silvia Andreozzi
    • 1
  • Daniela Spettoli
    • 2
  • Manuela Giangreco
    • 3
  • Monica Vichi
    • 4
  • Marzia Loghi
    • 5
  • Serena Donati
    • 1
  • the Regional maternal mortality working group
  1. 1.National Centre for Disease Prevention and Health PromotionIstituto Superiore di Sanità - Italian National Institute of HealthRomeItaly
  2. 2.SaPeRiDoC -Documentation Centre on Perinatal and Reproductive Health, Primary Care ServiceRegional Health Authority of Emilia-RomagnaBolognaItaly
  3. 3.Clinical Epidemiology and Public Health Research UnitInstitute for Maternal and Child Health - IRCCS Burlo GarofoloTriesteItaly
  4. 4.Service of StatisticsIstituto Superiore di Sanità - Italian National Institute of HealthRomeItaly
  5. 5.Integrated System for Health, Social Assistance, Welfare and Justice - Directorate for Social Statistics and Population Census – ISTATRomeItaly

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