New study provides insights into complicating factors surrounding perinatal deaths

Suicide is a leading cause of death during pregnancy and in the months after delivery in the United States, but many of these deaths may be preventable, say University of Michigan researchers.

A new mixed-methods study published in JAMA Network Open looks at the circumstances associated with perinatal suicide as well as how the circumstances vary across the perinatal period, using the Centers for Disease Control and Prevention National Violent Death Reporting System data.

The U-M authors found that mental health conditions, substance use and intimate partner problems represent important precipitating circumstances for perinatal suicide.

The study used data from more than 1,100 women who died while pregnant or within a year after giving birth and whose deaths were listed either as suicides or due to undetermined causes. The researchers compared data of the individuals with data from more than 17,600 women aged 10-50 who did not have a pregnancy in the last year.

“We should do everything we can to prevent these suicides. We owe it to these women and their families,” said lead author Kara Zivin, professor of psychiatry and obstetrics and gynecology at the U-M Medical School and professor of health management and policy at the U-M School of Public Health.

“Our study highlights the need for policies and practices targeting mental health, substance use and intimate partner problems as part of a strategic approach to reducing perinatal suicide risk.”

Zivin co-authored the study with Briana Mezuk, professor of epidemiology and director of the Center for Social Epidemiology and Population Health at the U-M School of Public Health. Together, they serve as principal investigators of the Aging, Transitions over the Lifespan, and Suicide Study, which explores how major life events, including pregnancy, impact suicide risk.

“This work suggests that pregnancy is a period of transition in people’s lives when preexisting factors that contribute to suicide risk can come together in various ways, in addition to social, psychological and biological risk factors that are part of the perinatal period itself,” Mezuk said.

Study co-authors with Zivin and Mezuk include: Chuwen Zhong, Alejandro Rodríguez-Putnam, Emma Spring, Qingyi Cai, Alyson Miller, Lily Johns, Viktoryia Kalesnikava and Anna Courant.