Parenthood and lower risk of suicide in women and men: the total Swedish population followed across adulthood

Abstract

Background: Previous studies suggest a protective effect of parenthood on suicide, but little is known about how the association may change across the lifespan, or in relation to sex, marital status or occurrence of psychiatric disorders.

Methods: We followed a cohort of over 5 million Swedish women and men, from 1991 to 2011, up to max. age 75, for death by suicide using national registers. Information on childbirths/adoptions, potential confounders and modifying factors were obtained from national registers. We assessed the associations between parenthood and suicide across adulthood using within time-stratified Cox regression models, with parenthood as a time-dependent exposure.

Results: Parents had a lower risk of suicide than non-parents across the lifespan, after adjusting for sociodemographic factors. The association was most pronounced in young adults, especially young women, but attenuated with increasing age and converged between sexes in older age groups. The lower risk of suicide over the life course was similar whether parents were married, unmarried or divorced, apart from married men; among them, parents only had a lower risk above age 55. The lower risk in parents was also evident in people with a history of psychiatric hospitalizations, but disappeared from age 55 in this population.

Conclusion: The lower risk of suicide was present in both parents, was most pronounced in young adulthood and weakened with increasing age. Our results are consistent with a plausible mechanism where feelings of responsibility and connectedness are protective against suicide in parents.

Keywords: Cohort; Epidemiology; Life course; Parents; Suicide.

Fig. 1

Association between parenthood and suicide 1991–2011 in women and men, by age group (the age denotes the highest age reached in each 5-year interval). Hazard ratios (HRs) with 95% confidence intervals associated with having at least one child, compared with having no children (at HR = 1). Adjusted for birth year, country of birth, attained education and neighbourhood characteristics (deprivation, population density and proportion of migrants/children of migrants)

Fig. 2

Suicide in parents, distributed by the age of their youngest child, in women and men who died by suicide before the child turned 30 years old

Fig. 3

Association between parenthood and suicide, stratified by marital status. HRs with 95% CIs associated with having at least one child, compared with having no children. Adjusted for birth year, country of birth, attained education and neighbourhood characteristics (deprivation, population density and proportion of migrants/children of migrants)

Fig. 4

Association between parenthood and suicide 1991–2011, by age group, stratified by lifetime psychiatric diagnosis in inpatient care, in a women and b men. HRs with 95% CIs associated with having at least one child, compared with having no children. Adjusted for birth year, country of birth, attained education and neighbourhood characteristics (deprivation, population density and proportion of migrants/children of migrants)