The prevalence of suicidal behavior and ideation during pregnancy and postpartum period, its variation in the COVID-19 pandemic, and the related factors: A systematic review and meta-analysis of observational studies

IF 2.5 4区 医学 Q2 PSYCHIATRY
Zekiye Karaçam , Ezgi Sarı , Rüveyda Yüksel , Hülya Arslantaş
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引用次数: 0

Abstract

Bacground

Pregnancy and postpartum are sensitive periods for mental health problems due to increased stressors and demands, and the prevalence of intentional self-harming behaviors such as suicidal behavior and ideation may increase. Changes in the provision of prenatal care services and utilization of health services and adverse living conditions during the COVID-19 epidemic may also trigger or exacerbate mental illnesses.

Aims

To investigate the prevalence of suicidal behavior and ideation encountered during pregnancy and postpartum period, its change in the COVID-19 pandemic, and the related factors.

Methods

A systematic review and meta-analysis of observational studies was conducted. A search was conducted in April 2021 and updated in April 2023 on Web of Science, PubMed, PsycINFO, EBSCO, Turk Medline, Turkish Clinics, and ULAKBIM databases. Two authors independently conducted the search, selection of articles, data extraction, and quality assessment procedures, and an experienced researcher controlled all these steps. Joanna Briggs Institute's Critical Appraisal Checklists were used to assess the quality of the studies.

Results

The meta-analysis included 38 studies and the total sample size of the studies was 9 044 991. In this meta-analysis, the prevalence of suicidal behavior in women during pregnancy and postpartum periods was 5.1 % (95 % CI, 0.01–1.53), suicidal ideation 7.2 % (95 % CI, 0.03–0.18), suicide attampt 1 % (95 % CI, 0.00–0.07) and suicidal plan 7.8 % (95 % CI, 0.06–0.11). Rate of suicidal behavior, ideation/thought increased and attempts in the pandemic process (2.5% vs 19.7 %; 6.3% vs 11.3 %; 3.6% vs 1.4 %, respectively). Prevalences of suicidal behavior, ideation, attempts, and plan in the postpartum period was higher than during pregnancy (1.1% vs 23.4 %; 6.1% vs 9.2 %; 0.5% vs 0.7 %; 7.5% vs 8.8 %, respectively). This systematic review showed that suicidal behavior increases due to many factors such as individual and obstetric characteristics, economic and socio-cultural factors, domestic violence, and a history of physical and mental illness.

Conclusion

This study revealed that suicidal behavior in the perinatal period is quite common, especially in high-risk groups, and it increases even more during the pandemic period. Being aware of the sensitivity of the perinatal period in terms of suicidal behavior, healthcare professionals can improve mother-baby health by identifying high-risk groups and providing preventive and health-promoting services.

Registration number: CRD42021246334.

孕期和产后自杀行为和意念的发生率、其在 COVID-19 大流行中的变化以及相关因素:观察性研究的系统回顾和荟萃分析
背景由于压力和需求的增加,孕期和产后是精神健康问题的敏感期,自杀行为和自杀意念等有意自我伤害行为的发生率可能会增加。目的 探讨孕期和产后自杀行为和意念的发生率、其在 COVID-19 流行期间的变化及相关因素。方法 对观察性研究进行系统回顾和荟萃分析。该研究于 2021 年 4 月在 Web of Science、PubMed、PsycINFO、EBSCO、Turk Medline、Turkish Clinics 和 ULAKBIM 数据库中进行了检索,并于 2023 年 4 月进行了更新。两位作者独立完成了检索、文章选择、数据提取和质量评估程序,并由一位经验丰富的研究人员控制所有这些步骤。乔安娜-布里格斯研究所(Joanna Briggs Institute)的 "批判性评估检查表"(Critical Appraisal Checklists)用于评估研究的质量。在这项荟萃分析中,孕期和产后妇女的自杀行为发生率为 5.1 %(95 % CI,0.01-1.53),自杀意念发生率为 7.2 %(95 % CI,0.03-0.18),自杀企图发生率为 1 %(95 % CI,0.00-0.07),自杀计划发生率为 7.8 %(95 % CI,0.06-0.11)。在大流行过程中,自杀行为、意念/想法和自杀未遂的比例分别增加了(2.5% vs 19.7%;6.3% vs 11.3%;3.6% vs 1.4%)。产后自杀行为、意念、企图和计划的发生率高于孕期(分别为 1.1% vs 23.4 %;6.1% vs 9.2 %;0.5% vs 0.7 %;7.5% vs 8.8 %)。本系统综述显示,自杀行为的增加受多种因素影响,如个人和产科特征、经济和社会文化因素、家庭暴力以及身心疾病史。认识到围产期自杀行为的敏感性,医护人员可以通过识别高危人群并提供预防和促进健康的服务来改善母婴健康:注册编号:CRD42021246334。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.90
自引率
0.00%
发文量
40
审稿时长
43 days
期刊介绍: The European journal of psychiatry is a quarterly publication founded in 1986 and directed by Professor Seva until his death in 2004. It was originally intended to report “the scientific activity of European psychiatrists” and “to bring about a greater degree of communication” among them. However, “since scientific knowledge has no geographical or cultural boundaries, is open to contributions from all over the world”. These principles are maintained in the new stage of the journal, now expanded with the help of an American editor.
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