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Maternal suicide in Italy

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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.

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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.

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Authors and Affiliations

  1. National Centre for Disease Prevention and Health Promotion, Istituto Superiore di Sanità - Italian National Institute of Health, Rome, Italy

    Ilaria Lega, Alice Maraschini, Paola D’Aloja, Silvia Andreozzi & Serena Donati

  2. SaPeRiDoC -Documentation Centre on Perinatal and Reproductive Health, Primary Care Service, Regional Health Authority of Emilia-Romagna, Bologna, Italy

    Daniela Spettoli

  3. Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health - IRCCS Burlo Garofolo, Trieste, Italy

    Manuela Giangreco

  4. Service of Statistics, Istituto Superiore di Sanità - Italian National Institute of Health, Rome, Italy

    Monica Vichi

  5. Integrated System for Health, Social Assistance, Welfare and Justice - Directorate for Social Statistics and Population Census – ISTAT, Rome, Italy

    Marzia Loghi

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  1. Ilaria Lega
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  2. Alice Maraschini
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  3. Paola D’Aloja
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  4. Silvia Andreozzi
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  6. Manuela Giangreco
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  7. Monica Vichi
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  8. Marzia Loghi
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Consortia

the Regional maternal mortality working group

  • Salvatore Alberico
  • , Antonello Antonelli
  • , Simona Asole
  • , Vittorio Basevi
  • , Silvana Borsari
  • , Irene Cetin
  • , Gabriella Dardanoni
  • , Domenico Di Lallo
  • , Valeria Dubini
  • , Cinzia Germinario
  • , Lisa Gnaulati
  • , Camilla Lupi
  • , Giuseppe Loverro
  • , Pasquale Martinelli
  • , Arianna Mazzone
  • , Luca Merlino
  • , Alessandra Meloni
  • , Lorenzo Monasta
  • , Luisa Mondo
  • , Davide Parisi
  • , Marcello Pezzella
  • , Arianna Polo
  • , Monia Puglia
  • , Raffaella Rusciani
  •  & Fabio Voller

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Correspondence to Ilaria Lega.

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Lega, I., Maraschini, A., D’Aloja, P. et al. Maternal suicide in Italy. Arch Womens Ment Health 23, 199–206 (2020). https://doi.org/10.1007/s00737-019-00977-1

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