Jan. 11, 2024 – A pair of new studies of women living in Sweden suggests that any woman who has depression during or after pregnancy has a higher and longer risk of suicide, regardless of psychiatric history.
Women who are diagnosed with depression during pregnancy or treated for depression within a year of giving birth are three times more likely to have suicidal behavior than pregnant women not affected by depression during those periods, according to findings published Tuesday in JAMA Network Open.
Perinatal depression affects up to 1 in 5 pregnant women in the U.S., and in 2021 there were nearly 3.7 million live births nationwide, pointing toward an increased suicide risk among hundreds of thousands of women each year.
The researchers analyzed the likelihood of suicidal behavior among women with perinatal depression, compared to pregnant women of the same age with similar due dates who did not have depression. Suicidal behavior included attempting or completing suicide. The study followed 925,061 pregnant women living in Sweden for up to 18 years after delivery, and also included an analysis that compared the women with perinatal depression to their sisters who did not have perinatal depression.
For the study, researchers defined perinatal depression as having a first depression diagnosis documented during pregnancy, or having an antidepressant medication prescription filled within a year of giving birth. A total of 86,551 women in the study met the depression criteria, and all gave birth between 2001 and 2017.
The highest risk of an unnatural death occurred during the year after diagnosis, but stayed higher for as long as 18 years, which was the duration of the study.
The researchers said in a news release that psychiatric treatment should not be discontinued during pregnancy and emphasized the importance of screening for depression before and after birth.
A second study that also looked at many of the same data about women with perinatal depression in Sweden was published Wednesday in BMJ, the journal of the British Medical Association. It showed that the increased risk of suicide among women with perinatal depression could not entirely be explained by family factors (many psychiatric illnesses have familial links), and having a preexisting psychiatric condition before pregnancy also didn’t explain the increased risk of suicide.
The second study showed that women with perinatal depression were almost twice as likely to die of natural or unnatural causes, compared to pregnant women who did not have the condition.
A news release summarizing the findings called the incidence of suicide “rare, but women with perinatal depression were more than six times as likely to die from suicide, and three times as likely to die from an accident, than women who did not have perinatal depression,” according to the summary from the BMJ press office.
“This finding was not surprising because depression is one of the most common psychiatric disorders in the postpartum period,” the BMJ study authors wrote. They said “early detection and treatment are needed for groups at high risk of perinatal depression to prevent the fatal outcomes.”