Author(s)

Akosua Adu¹, Sabrina V. Brown^2*, Ibitola Asaolu³, Wayne Sanderson⁴

¹Center for Health Services Research, University of Kentucky, Lexington, KY, USA.
²Department of Epidemiology, College of Public Health University of Kentucky, Lexington, KY, USA.
³Mel and Enid Zuckerman College of Public Health University of Arizona, Tucson, AZ, USA.
⁴Department of Epidemiology, College of Public Health University of Kentucky, Lexington, KY, USA.

Background: Suicide rates in the United States have increased by 30% since 1999 and suicide is currently the 10^th leading cause of death. Suicide has also become one of the leading causes of death in pregnant and postpartum women. The aim of this study is to examine whether rurality affects the risk of suicide in pregnant and postpartum women. Methods: This study used data from the National Violent Death Reporting System, Restricted Access Dataset (2003-2012). Bivariate and multivariate analyses were used to first describe the pregnant and postpartum population versus non-pregnant females (ages 15 - 54), who all died by suicide, and then to examine urban-rural differences. Results: Rural suicide decedents were much older, married, less likely to have had a mental health diagnosis, and more likely to use a firearm. Recent intimate partner crisis and intimate partner problems were both associated with increased odds that the suicide decedent was pregnant or postpartum in both urban and rural counties, whereas presence of job problems and report of history of suicide attempt decreased the odds that the suicide decedent was pregnant or postpartum in both urban and rural counties. Multivariable polytomous logistic regression analyses revealed differences in suicide risk factors among pregnant, postpartum and non-pregnant decedents when stratified by rural and urban status. Conclusion: Our findings suggest that pregnant and postpartum women should be screened for risk of suicide, in the clinical setting, especially if there are intimate partner problems or a crisis. With proper identification and response, suicide in pregnant and postpartum women might be decreased.

Suicide, Rural, Urban, Pregnant, Non-Pregnant, Postpartum

Adu, A. , Brown, S. , Asaolu, I. and Sanderson, W. (2019) Understanding Suicide in Pregnant and Postpartum Women, Using the National Violent Death Reporting System Data: Are There Differences in Rural and Urban Status?. Open Journal of Obstetrics and Gynecology, 9, 547-565. doi: 10.4236/ojog.2019.95054.