Pregnancy-related suicide deaths between 2004-2014 in Antioquia (Colombia)
DOI:
https://doi.org/10.18597/rcog.3125Keywords:
Maternal health, suicide, maternal mortalityAbstract
Objective: To characterise the population of women who died as a result of suicide during pregnancy, delivery and the postpartum period in the Department of Antioquia between 2004 and 2014, and to estimate the proportion of deaths due to suicide.
Materials and methods: Descriptive study of suicide deaths during pregnancy, delivery and the postpartum period in women living in the Department of Antioquia, in central Colombia, identified between 2004 and 2014. All the cases identified from the National Public Health Surveillance (SIVIGILA) reporting system and death certificates were included. Data were taken from clinical records and charts. Clinical and sociodemographic characteristics were assessed. Risk factors taken into consideration included a personal or family history of mental disorder, the use of psychoactive substances, attempted suicide, domestic violence and intimate partner violence. Categorical variables were grouped according to frequency in terms of proportions and percentages; medians and inter-quartile ranges were calculated for continuous variables. The proportion of suicide deaths was calculated over the total number of maternal deaths which occurred in the Department during the study period, and the mortality ratio was calculated specifically by age groups taking into consideration the number of deaths identified in the research by age group and the total number of live births reported by DANE in women of that age during the 11-year period, expressed as number of maternal deaths/1000 live births.
Results: Between 2004 and 2014 there were a total of 476 maternal deaths and 24 cases of suicide death, for a proportion of 4.8%. Data were available for descriptions in 18 cases. The highest number of suicide deaths occurred in the age group between 20 and 29 years, single women, housewives or students, living in rural areas, affiliated to the subsidised healthcare regime and with less than complete secondary education and one-half of the patients had attended prenatal care visits. Deaths were due to poisoning and 30% were suicide by hanging. There was a similar distribution between the deaths that occurred in the first two trimesters of pregnancy and the late postpartum period. Here were no data in the personal history of risk factors for suicide in 44.4% of cases, or in the family history in 72.2% of cases.
Conclusions: Pregnancy-related suicide deaths are an important cause of potentially avoidable maternal mortality. Identification of vulnerable patients is required in order to offer active treatment and reinforce follow-up. Greater commitment is needed in terms of event documentation, notification, follow-up and analysis.Author Biographies
Natalia Sofía Aguirre-Martínez
Especialista en Obstetricia y Ginecología, Universidad de Antioquia, Medellín (Colombia).
Gladis Adriana Vélez-Álvarez
Especialista en Obstetricia y Ginecología, magíster en Salud Pública. Docente, NACER, Salud Sexual y Reproductiva - Departamento de Obstetricia y Ginecología, Universidad de Antioquia, Medellín
(Colombia).
John Jairo Zuleta-Tobón
Especialista en Obstetricia y Ginecología, magíster en Epidemiología. Docente, NACER, Salud Sexual y Reproductiva - Departamento de Obstetricia y Ginecología, Universidad de Antioquia, Medellín (Colombia). jjzuleta@une.net.co
MO
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