A recent population-based case-control study published in the American Journal of Obstetrics & Gynecology used Washington State birth certificates linked to hospital discharge data to evaluate the association between hospitalization for a psychiatric illness before delivery and risk of postpartum suicide attempt. The study compared women hospitalized for a postpartum suicide attempt (n = 355) with a group of controls who had not been hospitalized (n = 1420).

Women previously hospitalized with a psychiatric disorder were approximately 27 times more likely to attempt suicide during the postpartum period than controls with no history. Those who were hospitalized within one year of delivery were at highest risk. Those with a substance use disorder were at a 6.2-fold increased risk, and those with a dual diagnosis were at an 11.1-fold increased risk of postpartum suicide attempt compared with controls.

This study is consistent with previous studies indicating that a history of psychiatric illness prior to delivery predicts risk of postpartum illness. It underscores the importance of screening for both psychiatric illness and substance abuse disorders prior to delivery in order to identify women at greatest risk for postpartum illness and suicide attempt. This population requires more careful follow-up and monitoring during the postpartum period.

Ruta Nonacs, MD PhD

Comtois KA, Schiff MA, Grossman DC. Psychiatric risk factors associated with postpartum suicide attempt in Washington State, 1992-2001. American Journal of Obstetrics & Gynecology 2008. 199(2):120.