Suicide as a cause of maternal mortality in the postpartum period in Spain.

Abstract

Introduction: The postpartum period carries a high risk of suicide, one of the leading causes of maternal death in Europe. This study analyzes the incidence of suicide as a cause of maternal mortality within the first postpartum year in Spain.

Materials and methods: Data were obtained from the National Institute of Statistics. Suicide records in Spain (2016-2023) were linked to birth and birth-loss certificates. Suicides during pregnancy or after losses <22 weeks were excluded due to lack of national registration data. Variables included year of death, maternal age, and time from delivery to death. Analyses were descriptive. The study was approved by the Research Ethics Committee of Almería (June 26, 2024; SUICIDE_POSPARTO 37/2024).

Results: Thirty women died by suicide during the first postpartum year between 2016 and 2023. Eighty percent of cases involved women aged 30-40 years. Half of the suicides occurred within the first five months postpartum, with 83.3% classified as late maternal mortality (between day 43 postpartum and the end of the first year). The highest maternal mortality ratio due to suicide was recorded in 2017, at 0.76 per 100,000 live births (three cases), followed by 2022 with 0.61 (two cases). In contrast, late maternal mortality due to suicide was highest in 2016, with a ratio of 1.70 per 100,000 live births.

Conclusions: This is the first study to publish data on suicide in the first postpartum year in Spain, contributing to the national maternal mortality registry. Research on suicidal behavior and prevention strategies during pregnancy and postpartum remains a priority.