Prevalence of suicidal thoughts and factors affecting it in pregnant women, 2022

Document Type : Original Article

Authors

1 M.Sc of Midwifery Counselling, Counseling and Reproductive Health Research Center, School of Nursing and Midwifery, Golestan University of Medical Sciences, Gorgan, Iran.

2 Ph.D. student in Statistical Sciences, Department of Statistical Sciences Sapienza University of Rome, Italy.

3 Ph.D of Counseling, Health Management and Social Development Research Center, Golestan University of Medical Sciences, Gorgan, Iran.

4 Assistant Professor, Department of Midwifery, Ph.D of Higher Education Management, Counseling and Reproductive Health Research Center, School of Nursing and Midwifery, Golestan University of Medical Sciences, Gorgan, Iran.

10.22038/ijogi.2024.73931.5799

Abstract

Introduction: Suicidal thought is an important predictive factor for committing suicide. One of the causes of the death of pregnant women is attempting suicide, so identifying its risk factors can be effective on policies aimed at reducing this problem. Therefore, the present study was conducted with aim to investigate the prevalence of suicidal thoughts and the factors influencing it in pregnant women.
Methods: A cross-sectional study with a descriptive-analytical approach was conducted through a census in 2022 on 515 pregnant women under the care of 10 urban comprehensive health service centers in Aliabad Katoul city. The Persian version of Beck's Suicide Ideation Scale, the Persian version of the Goldberg General Health Questionnaire, and the HITS domestic violence screening form were the study tools. Using these instruments, the prevalence of suicidal thoughts and its relationship with mental health, physical health, domestic violence, sleep disorders, anxiety, and depression was examined. Data analysis was performed using SPSS statistical software (version 23) and included Spearman correlation, Chi-square tests, Fisher's exact test, and multiple logistic regressions. A p-value of less than 0.05 was considered significant.
Results: The prevalence of suicidal ideation was 7.9%. The level of suicidal ideation of pregnant women was low. Mental health of pregnant women was in the category of morbid symptoms. Age less than 25 years old, unwanted pregnancy, pregnancy more than 4 times, childbirth more than 4 times, having 4 or more children and high risk behavior of the spouse showed a statistically significant relationship with suicidal ideation (p=0.05).
Conclusion: Considering the low mental health of pregnant women, there is a need for planning to carry out necessary interventions and continuous screenings of pregnant women in order to promote and ensure the mental health of pregnant women, especially women suffering from domestic violence.

Keywords

Main Subjects


  1. Zhang L, Yang Y, Li M, Zhou X, Zhang K, Yin X, et al. The prevalence of suicide ideation and predictive factors among pregnant women in the third trimester. BMC pregnancy and childbirth 2022; 22(1):266.
  2. Goldman-Mellor SJ, Caspi A, Harrington H, Hogan S, Nada-Raja S, Poulton R, et al. Suicide attempt in young people: a signal for long-term health care and social needs. JAMA psychiatry 2014; 71(2):119-27.
  3. Belete K, Kassew T, Demilew D, Amare Zeleke T. Prevalence and correlates of suicide ideation and attempt among pregnant women attending antenatal care services at public hospitals in southern Ethiopia. Neuropsychiatric disease and treatment 2021: 1517-29.
  4. Gressier F, Guillard V, Cazas O, Falissard B, Glangeaud-Freudenthal NM, Sutter-Dallay AL. Risk factors for suicide attempt in pregnancy and the post-partum period in women with serious mental illnesses. Journal of Psychiatric Research 2017; 84:284-91.
  5. Esscher A, Essen B, Innala E, Papadopoulos FC, Skalkidou A, Sundström-Poromaa I, et al. Suicides during pregnancy and 1 year postpartum in Sweden, 1980–2007. The British Journal of Psychiatry 2016; 208(5):462-9.
  6. Shiraly R, Kokabi E. Prevalence and factors Associated with suicidal ideation in General population of Shiraz, 2017. Journal of Ilam University of Medical Sciences 2019; 27(3):27-36.
  7. World Health Organization. Regional Office for the Eastern Mediterranean. Health profile 2015. Islamic Republic of Iran. Available from: http://applications.emro.who.int/dsaf/EMROP UB_201 6_EN_19265.pdf?ua=1.
  8. Kalmbach DA, Cheng P, Ong JC, Ciesla JA, Kingsberg SA, Sangha R, et al. Depression and suicidal ideation in pregnancy: exploring relationships with insomnia, short sleep, and nocturnal rumination. Sleep medicine 2020; 65:62-73.
  9. National Collaborating Centre for Mental Health, National Institute for Health and Clinical Excellence. Antenatal and postnatal mental health: clinical management and service guidance. British Psychological Society and Gaskell; 2008.
  10. Noorbala AA, Afzali HM, Abedinia N, Akhbari M, Moravveji A, Vaseghi F, et al. Mental health status and marital satisfaction of pregnant women referring to health centers in Kashan, Iran. Journal of School of Public Health & Institute of Public Health Research 2018; 16(3).
  11. Rezaiyan MK, Jarahi L, Moharreri F, Afshari R, Motamedalshariati SM, Okhravi N, et al. Epidemiology of suicide attempts in Khorasan Razavi Province, 2014-2015. Iranian journal of epidemiology 2017; 13(2).
  12. Sullins DP. Affective and substance abuse disorders following abortion by pregnancy intention in the United States: a longitudinal cohort study. Medicina 2019; 55(11):741.
  13. MosaFarkhany, Khooban, EftekhariGol, KhosraviAsl. Suicide in Iran: a systematic review of successful suicide rate. Beyhagh 2015; 18(1):38-43.
  14. Bedaso A, Adams J, Peng W, Sibbritt D. The relationship between social support and mental health problems during pregnancy: a systematic review and meta-analysis. Reproductive health 2021; 18:1-23.
  15. Lencha B, Ameya G, Baresa G, Minda Z, Ganfure G. Intimate partner violence and its associated factors among pregnant women in Bale Zone, Southeast Ethiopia: A cross-sectional study. PloS one 2019; 14(5):e0214962.
  16. World Health Organization. Violence against women. Key facts. Available at: https://www.who.int/news-room/fact-sheets/detail/violence-against-women; 2017.
  17. Sherin KM, Sinacore JM, Li XQ, Zitter RE, Shakil A. HITS: a short domestic violence screening tool for use in a family practice setting. Family Medicine-Kansas City 1998; 30:508-12.
  18. Shirzadi M, Fakhari A, Tarvirdizadeh K, Farhang S. Psychometric properties of hits screening tool (Hurt, insult, threaten, scream) in detecting intimate partner violence in Iranian women. Shiraz E Medical Journal 2020; 21(3):e91924.
  19. Khodabande F, Nourbala A, Kahani S, Bagheri A. A study on the factors that associated with attempting suicide in middle and old age. Health Psychology 2012; 1(1):81-92.
  20. Anisi J, Fathi AA, Salimi S, Ahmadi NK. Validity and reliability of Beck suicide scale ideation among soldiers. Journal of Military Medicine 2005; 7(1):33-37.
  21. Akbarzadeh MA, Sharif FA, Zare NA, Ghodrati F. Prevalence of symptoms post-partum anxiety and baby blues and factors effective uponit in women with high risk pregnancies. Journal of Family Research 2009; 5(1):57-71.
  22. Nazifi M, Mokarami HR, Akbaritabar AK, Faraji Kujerdi M, Tabrizi R, Rahi A. Reliability, validity and factor structure of the persian translation of general health questionnire (ghq-28) in hospitals of kerman university of medical sciences. Journal of advanced biomedical sciences 2013; 3(4):336-42.
  23. Taghavi S. Validity and reliability of the general health questionnaire (ghq-28) in college students of shiraz university. J psychol 2002; 5(4):381-98.
  24. Williams P, Wilkinson G, Rawnsley K, editors. The scope of epidemiological psychiatry: Essays in honour of Michael Shepherd. Routledge; 2018.
  25. Yaghubi N, Nasr M, Shahmohammadi D. Epidemiology of mental disorders in urabn and rural areas of Sowmaesara-Gillan. Iranian Journal of Psychiatry and Clinical Psychology 1995; 1(4):55-60.
  26. Golshani F, Gholmohammad NG, Aghdasi AN. The Effectiveness of Teaching Life Skills During Pregnancy on Pregnant Mothers’mental Health. Journal of Educational Sciences 2014; 7(26):89-101.
  27. Anbesaw T, Negash A, Mamaru A, Abebe H, Belete A, Ayano G. Suicidal ideation and associated factors among pregnant women attending antenatal care in Jimma medical center, Ethiopia. PLoS one 2021; 16(8):e0255746.
  28. Onah MN, Field S, Bantjes J, Honikman S. Perinatal suicidal ideation and behaviour: psychiatry and adversity. Archives of women's mental health 2017; 20:321-31.
  29. Moustafa MA, Youssef UM, Sleem NF, Mohamed El-Hanafy RH. Prevalence and associated factors of suicide among pregnant women At Zagazig University Hospitals. Zagazig University Medical Journal 2019; 25(2):216-26.
  30. Tabb KM, Gavin AR, Faisal-Cury A, Nidey N, Chan YF, Malinga T, et al. Prevalence of antenatal suicidal ideation among racially and ethnically diverse WIC enrolled women receiving care in a Midwestern public health clinic. Journal of affective disorders 2019; 256:278-81.
  31. Reid HE, Pratt D, Edge D, Wittkowski A. Maternal suicide ideation and behaviour during pregnancy and the first postpartum year: a systematic review of psychological and psychosocial risk factors. Frontiers in psychiatry 2022; 13:765118.
  32. Asad N, Karmaliani R, Sullaiman N, Bann CM, McClure EM, Pasha O, et al. Prevalence of suicidal thoughts and attempts among pregnant Pakistani women. Acta obstetricia et gynecologica Scandinavica 2010; 89(12):1545-51.
  33. Alhusen JL, Frohman N, Purcell G. Intimate partner violence and suicidal ideation in pregnant women. Archives of women's mental health 2015; 18:573-8.
  34. Mojibian M, Mirhoseini H, Asadpour M, Pourrashidi Boshrabadi A, Hosseinpoor S, Rezahosseini O, et al. Frequency of suicidal thoughts and attempt in pregnant women referred to four hospitals of Yazd City, Iran in 2011. J Sci Technol 2014; 4(1):31-8.
  35. Benute GR, Nomura RM, Jorge VM, Nonnenmacher D, Fráguas Junior R, Lucia MC, et al. Risk of suicide in high risk pregnancy: an exploratory study. Revista da Associação Médica Brasileira 2011; 57:583-7.
  36. Oreizi H. A meta-analysis of the effectiveness of psychological interventions on postpartum depression in Iran, considering to the moderating role of therapeutic intervention. Advances in Nursing & Midwifery 2017; 26(95):33-43.
  37. Ayehu M, Solomon T, Lemma K. Socio-demographic characteristics, clinical profile and prevalence of existing mental illness among suicide attempters attending emergency services at two hospitals in Hawassa city, South Ethiopia: a cross-sectional study. International journal of mental health systems 2017; 11:1-9.