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. 2022 Apr 23;19(9):5118.
doi: 10.3390/ijerph19095118.

Association of Postpartum Depression with Maternal Suicide: A Nationwide Population-Based Study

Yi-Liang Lee  1   2 , Yun Tien  3 , Yin-Shiuan Bai  2   4 , Chi-Kang Lin  1 , Chang-Sheng Yin  1   2 , Chi-Hsiang Chung  5   6   7 , Chien-An Sun  8   9 , Shi-Hao Huang  5   6   10 , Yao-Ching Huang  5   6   10 , Wu-Chien Chien  4   5   6   7 , Chieh-Yi Kang  11 , Gwo-Jang Wu  1   2   5
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Association of Postpartum Depression with Maternal Suicide: A Nationwide Population-Based Study

Yi-Liang Lee et al. Int J Environ Res Public Health. .

Abstract

Background: To examine the association of postpartum depression (PPD) with maternal suicide in the Taiwanese population.

Methods: We examined the medical records of women aged 18-50 years who experienced childbirth and had PPD (the study cohort, n = 2882), who experienced childbirth but did not have PPD (comparison cohort 1, n = 5764), and who neither experienced childbirth nor had PPD (comparison cohort 2, n = 5764) between 2000 and 2015. The patients were followed up until suicide, withdrawal from the National Health Insurance program, or 31 December 2015.

Results: The rates of anxiety and depression symptoms, as well as the cumulative risk of suicide, were significantly higher in the study cohort. PPD was significantly correlated with an increased risk of maternal suicide and was associated with a greater risk of developing comorbidities such as hypertension, diabetes mellitus, hyperlipidemia, and stroke. The comparison cohorts did not differ significantly in terms of suicide risk.

Conclusion: PPD was associated with a significantly higher rate of suicide and a shorter time to suicide after childbirth. Younger age, winter, and subclinical depression and anxiety positively predicted suicide in the study cohort. To prevent maternal suicide, clinicians should be observant of subclinical depression and anxiety symptoms among patients.

Keywords: depression; postpartum; puerperal disorders; suicide.

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Conflict of interest statement

The authors declare no potential conflict of interest with respect to the publication of this article.

Figures

Figure 1
Figure 1
The flowchart of study sample selection. Abbreviations: PPD, postpartum depression; RT, radiotherapy; CT, chemotherapy.
Figure 2
Figure 2
Kaplan–Meier for cumulative risk of suicide among females aged 18–50 stratified by different cohorts with log-rank test. Delivery with PPD vs. delivery without PPD: Log-rank p < 0.001. Delivery with PPD vs. without delivery: Log-rank p < 0.001. Delivery without PPD vs. without delivery: Log-rank p = 0.892. Abbreviation: PPD, postpartum depression.
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