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Suicidality in early pregnancy among antepartum mothers in urban India


This study assessed the prevalence and predictors of suicidality among 462 pregnant women in South India. Women in early pregnancy (<20 weeks) attending an urban public hospital antenatal center were assessed for suicidality using a modified version of the Suicide Behaviors Questionnaire–Revised (SBQR) and a single-item (item 10) from the Edinburgh Postnatal Depression Scale (EPDS). Severity of depressive symptoms, family violence, and perceived social support were also measured. The prevalence of suicidality in pregnancy was 7.6 % (35/462). Eleven women (2.4 %) reported having had suicidal plans, and 8 (1.7 %) had made a suicidal attempt during the current pregnancy. Younger age, belonging to a middle socioeconomic status, poor perceived support, domestic violence, depressive symptoms, and having a past history of suicidality predicted suicidal ideation during the current pregnancy. Multivariate analysis revealed depression severity and a life time history of suicidal ideation as being the strongest predictors. The findings underscore the need for assessment of psychiatric and psychosocial factors that confer risk among women in this vulnerable period. The results of the study however may be specific to low-income urban women from this geographical location limiting the external validity of our findings.

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  • Alhusen JL, Frohman N, Purcell G (2015) Intimate partner violence and suicidal ideation in pregnant women. Arch Women Ment Hlth 573–578. doi:10.1007/s00737-015-0515-2

  • Asad N, Karmaliani R, Sullaiman N et al (2013) Prevalence of suicidal thoughts and attempts among pregnant Pakistani women. Acta Obstet 53:1689–1699. doi:10.1017/CBO9781107415324.004

    Google Scholar 

  • Bairwa M, Rajput M, Sachdeva S (2013) Modified Kuppuswamy’s socioeconomic scale: social researcher should include updated income criteria, 2012. Indian J Community Med 38:184–185. doi:10.4103/0970-0218.116358

    Article  Google Scholar 

  • Bowen A, Stewart N, Baetz M, Muhajarine N (2009) Antenatal depression in socially high-risk women in Canada. J Epidemiol Community Heal 63:414–416. doi:10.1136/jech.2008.078832

    Article  CAS  Google Scholar 

  • Brettingham M (2004) Depression and obesity are major causes of maternal death in Britain. Br Med J 329:1205. doi:10.1136/bmj.329.7476.1205

    Article  Google Scholar 

  • Castro E, Couto T, Brancaglion MYM, Cardoso MN et al (2015) Suicidality among pregnant women in Brazil: prevalence and risk factors. Arch Women Ment Hlth. doi:10.1007/s00737-015-0552-x

    Google Scholar 

  • Cox JL, Holden JM, Sagovsky R (1987) Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry 150(6):782–786

  • Da Silva RA, Da Costa OL, Jansen K et al (2012) Suicidality and associated factors in pregnant women in Brazil. Community Ment Health J 48:392–395. doi:10.1007/s10597-012-9495-0

    Article  PubMed  Google Scholar 

  • Devries K, Watts C, Yoshihama M et al (2011) Violence against women is strongly associated with suicide attempts: evidence from the WHO multi-country study on women’s health and domestic violence against women. Soc Sci Med 73:79–86. doi:10.1016/j.socscimed.2011.05.006

    Article  PubMed  Google Scholar 

  • Farias DR, Pinto TDJP, Teofilo MMA et al (2013) Prevalence of psychiatric disorders in the first trimester of pregnancy and factors associated with current suicide risk. Psychiatry Res 210:962–968. doi:10.1016/j.psychres.2013.08.053

    Article  PubMed  Google Scholar 

  • Fuhr DC, Calvert C, Ronsmans C, et al (2014) The contribution of suicide and injuries to pregnancy-related mortality in low and middle-income countries: a systematic review and meta-analysis. 1:213–225. doi: 10.1016/S2215-0366(14)70282-2.The

  • Gausia K, Fisher C, Ali M, Oosthuizen J (2009) Antenatal depression and suicidal ideation among rural Bangladeshi women: a community-based study. Arch Women Ment Health 12:351–358. doi:10.1007/s00737-009-0080-7

    Article  Google Scholar 

  • Gavin AR, Tabb KM, Melville JL et al (2011) Prevalence and correlates of suicidal ideation during pregnancy. Arch Women Ment Health 14:239–246. doi:10.1007/s00737-011-0207-5

    Article  Google Scholar 

  • Gentile S (2011) Suicidal mothers. J Inj Violence Res 3:90–97. doi:10.5249/jivr.v3i2.98

    Article  PubMed  PubMed Central  Google Scholar 

  • Hawton K (2000) Sex and suicide. Gender differences in suicidal behaviour. Br J Psychiatry 177:484–485

  • Healey C, Morriss R, Henshaw C et al (2013) Self-harm in postpartum depression and referrals to a perinatal mental health team: an audit study. Arch Women Ment Hlth 16:237–245. doi:10.1007/s00737-013-0335-1

    Article  Google Scholar 

  • Howard LM, Flach C, Mehay A et al (2011) The prevalence of suicidal ideation identified by the Edinburgh Postnatal Depression Scale in postpartum women in primary care: findings from the RESPOND trial. BMC Pregnancy Childbirth 11:57. doi:10.1186/1471-2393-11-57

    Article  PubMed  PubMed Central  Google Scholar 

  • Huang H, Faisal-Cury A, Chan Y-F et al (2012) Suicidal ideation during pregnancy: prevalence and associated factors among low-income women in São Paulo, Brazil. Arch Women Ment Hlth 15:135–138. doi:10.1007/s00737-012-0263-5

    Article  CAS  Google Scholar 

  • Indian Council of Medical Research (2011) Health consequences of domestic violence with special reference to reproductive health

    Google Scholar 

  • Lewis G, Drife J (2001) Why mothers die 1997–1999: the fifth report of the confidential enquiries into maternal death in the UK

    Google Scholar 

  • Lindahl V, Pearson JL, Colpe L (2005) Prevalence of suicidality during pregnancy and the postpartum. Arch Women Ment Hlth 8:77–87. doi:10.1007/s00737-005-0080-1

    Article  CAS  Google Scholar 

  • Melville JL, Gavin A, Guo YG et al (2010) Depressive disorders during pregnancy: prevalence and risk factors in a large urban sample. Obstet Gynecol 116:1064–1070. doi:10.1097/AOG.0b013e3181f60b0a

    Article  PubMed  PubMed Central  Google Scholar 

  • Mendez-Bustos P, Lopez-Castroman J, Baca-García E, Ceverino A (2013) Life cycle and suicidal behavior among women. Sci World J 2013:485851. doi:10.1155/2013/485851

    Article  Google Scholar 

  • Möller HJ (2003) Suicide, suicidality and suicide prevention in affective disorders. Acta Psychiatr Scand Suppl 108:73–80. doi:10.1034/j.1600-0447.108.s418.15.x

  • Newport DJ, Levey LC, Pennell PB et al (2007) Suicidal ideation in pregnancy: assessment and clinical implications. Arch Women Ment Hlth 10:181–187. doi:10.1007/s00737-007-0192-x

    Article  CAS  Google Scholar 

  • Oates M (2003) Suicide: the leading cause of maternal death Suicide : the leading cause of maternal death. Br J Psychiatry 279–281. doi: 10.1192/02-488

  • Osman A, Bagge CL, Gutierrez PM et al (2001) The Suicidal Behaviors Questionnaire-Revised (SBQ-R): validation with clinical and nonclinical samples. Assessment 8:443–454. doi:10.1177/107319110100800409

    Article  CAS  PubMed  Google Scholar 

  • Patel V, Ramasundarahettige C, Vijayakumar L et al (2012) Suicide mortality in India: a nationally representative survey. Lancet 379:2343–2351. doi:10.1016/S0140-6736(12)60606-0

    Article  PubMed  PubMed Central  Google Scholar 

  • Pinheiro RT, Coelho FMDC, Da Silva RA et al (2012) Suicidal behavior in pregnant teenagers in southern Brazil: social, obstetric and psychiatric correlates. J Affect Disord 136:520–525. doi:10.1016/j.jad.2011.10.037

    Article  PubMed  Google Scholar 

  • Qin P, Mortensen PB (2003) The impact of parental status on the risk of completed suicide. Arch Gen Psychiatry 60:797–802. doi:10.1001/archpsyc.60.8.797

    Article  PubMed  Google Scholar 

  • Schapira K, Linsley KR, Linsley JA et al (2001) Relationship of suicide rates to social factors and availability of lethal methods: comparison of suicide in Newcastle upon Tyne 1961–1965 and 1985–1994. Br J Psychiatry 178:458–464. doi:10.1192/bjp.178.5.458

    Article  CAS  PubMed  Google Scholar 

  • Shadigian E, Bauer S (2005) Pregnancy-associated death: a qualitative systematic review of homicide and suicide. Obstet Gynecol Surv 60:183–190. doi:10.1097/01.ogx.0000155967.72418.6b

    Article  PubMed  Google Scholar 

  • Stallones L, Leff M, Canetto SS et al (2007) Suicidal ideation among low-income women on family assistance programs. Women Health 45:65–83. doi:10.1300/J013v45n04_04

    Article  PubMed  Google Scholar 

  • Tabb KM, Gavin AR, Guo Y et al (2013) Views and experiences of suicidal ideation during pregnancy and the postpartum: findings from interviews with maternal care clinic patients. Women Health 53:519–535. doi:10.1080/03630242.2013.804024

    Article  PubMed  PubMed Central  Google Scholar 

  • Varma PK (2007) The great Indian middle class. Penguin Books India

  • Vijayakumar L (2015) Suicide in women. Indian J Psychiatry 57:233–238

    Article  Google Scholar 

  • Webster J, Linnane J, Dibley L et al (2000) Measuring social support in pregnancy: can it be simple and meaningful? Birth 27:97–101. doi:10.1046/j.1523-536x.2000.00097.x

    Article  CAS  PubMed  Google Scholar 

  • Zhong Q-Y, Gelaye B, Rondon MB, et al (2014) Using the Patient Health Questionnaire (PHQ-9) and the Edinburgh Postnatal Depression Scale (EPDS) to assess suicidal ideation among pregnant women in Lima, Peru. Arch Women Ment Hlth 783–792. doi: 10.1007/s00737-014-0481-0

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We acknowledge the funding for the PRAMMS project by the Indian Council of Medical Research, Grant Number 7/7/01PSRH/12-RCH

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Correspondence to Prabha S. Chandra.

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The authors declare that they have no competing interests.

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All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional ethics committee (IEC—NIMHANS).

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Supraja, T.A., Thennarasu, K., Satyanarayana, V.A. et al. Suicidality in early pregnancy among antepartum mothers in urban India. Arch Womens Ment Health 19, 1101–1108 (2016).

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  • Suicide
  • Pregnancy
  • Domestic violence
  • Women
  • India