Self-Injurious Thoughts and Behaviors From Pregnancy to Postpartum: Risk Factors and Clinical Implications.

Objective: Suicide is a leading cause of mortality among perinatal populations. Despite increasing rates, research on this topic remains limited. This paper examined (1) change in self-injurious thoughts and behaviors (SITBs) from pregnancy to postpartum, (2) associations between risk factors and SITBs, and (3) whether risk factors moderated change in SITBs.

Methods: Participants (N = 223) reported on SITBs, emotion dysregulation, and partner stress at the third trimester and 7 months postpartum, and childhood trauma at the third trimester. We tested study aims with generalized linear models.

Result: While self-injurious thoughts did not change from pregnancy to postpartum, the odds of self-injurious behaviors were 3.56 times higher postpartum (OR = 3.56, p = 0.011), even while accounting for risk factors. Higher concurrent emotion dysregulation was associated with self-injurious thoughts during pregnancy and postpartum (OR = 1.04, p < 0.001; OR = 1.05, p < 0.001) and with behaviors postpartum (OR = 1.05, p = 0.002). Childhood trauma was associated with self-injurious thoughts during pregnancy (OR = 2.54, p = 0.004) and postpartum (OR = 2.05, p = 0.028) and with behaviors postpartum (OR = 3.25, p = 0.009). Partner relationship conflict was not associated with self-injurious thoughts or behaviors at either time point. Higher rates of prenatal risk factors increased the odds of SITBs in the postpartum period.

Conclusion: Findings support interventions addressing childhood trauma and emotion dysregulation for prevention of SITBs before postpartum, when risk is higher.