Clinical Characteristics of Suicide Attempts During Pregnancy

Correspondence (İletişim): Nihat Müjdat Hökenek, M.D. Saglik Bilimleri Universitesi, Kartal Dr. Lutfi Kirdar Sehir Hastanesi, Acil Tip Anabilim Dali, Istanbul, Turkey Phone (Telefon): +90 555 320 14 19 E-mail (E-posta): nihathokenek@gmail.com Submitted Date (Başvuru Tarihi): 05.09. 2020 Accepted Date (Kabul Tarihi): 11.10. 2020 Copyright 2021 Haydarpaşa Numune Medical Journal OPEN ACCESS This is an open access article under the CC BY-NC license (http://creativecommons.org/licenses/by-nc/4.0/). 224 Hökenek et al., Clinical Characteristics of Suicide Attempts During Pregnancy / doi: 10.14744/hnhj.2020. 52296 a recent study, it was reported that 60% of the pregnant woman who died by suicide had a previous psychiatric history[14]. The estimated prevalence of prenatal depression is 25.3% in lowand middle-income countries, and maternal depression with comorbid anemia is the most common cause of maternal morbidity[15]. While completed suicides are associated with psychiatric diseases at a rate of 90% in high-income countries; suicidal thoughts and attempts are also associated with long-term unemployment and hunger in low-income countries[16,17]. In addition, low socioeconomic status, low levels of educational attainment, younger age, negative life events, and lack of social support are also associated with suicidal ideation[18,19]. Recent studies emphasize the association between suicidal thoughts and socioeconomic and cultural factors[20-22]. In a recent study, neither major depression nor anxiety disorder was diagnosed in the majority of women with suicidal thoughts or attempts[23]. Therefore, it is recommended that women should be asked for suicidal thoughts during their early pregnancy assessments. Suicide attempts are 20 times more often than completed suicides[24]. People die as a result of a suicide attempt, use more lethal methods, and have more severe psychopathology compared to those who attempt suicide[25]. In a study, most of the pregnant women who lost their lives by suicide used methods with high lethality such as hanging and jumping from high[26]. About 20% of people who attempted suicide die as a result of another suicide attempt[27]. From this point of view, having a history of a suicide attempt is the strongest predictor for a new attempt[28]. The aim of this study is to investigate the clinical characteristics of pregnant women who applied to the emergency service due to suicide attempt in İstanbul, Kartal. Materials and Methods This study is a retrospective observational study. Pregnant women who were admitted to Kartal Dr. Lütfi Kırdar City Hospital Emergency Department with suicide attempt between 2009 and 2019 were included in the study. The study was approved by the ethics committee at Kartal Dr. Lütfi Kirdar City Hospital in İstanbul, Turkey (Ethics Committee Ruling number: 2020/514/171/5). The demographic and clinical characteristics of the individuals included in the study were recorded to the case report form. Forty-six pregnant patients included in the study. Cases with taking accidental overdose from drug misuse were excluded from the study. All statistical analyses were performed using the Statistical Package for the Social Sciences-23 Windows program. Means and standard deviations (SD) were used for quantitative data, and numbers and percentages were used for qualitative data. The Shapiro–Wilk test was used to examine the normality of continuous data. The statistical significance level was accepted as p<0.05.