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Self-harm in pregnancy and the postnatal year: prevalence and risk factors.
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- Author(s): Ayre, Karyn; Liu, Xiaoqin; Howard, Louise M.; Dutta, Rina; Munk-Olsen, Trine
- Source:
Psychological Medicine. May2023, Vol. 53 Issue 7, p2895-2903. 9p. - Source:
- Additional Information
- Subject Terms: RISK factors of self-injurious behavior; PERSONALITY disorders; CONFIDENCE intervals; PREMATURE infants; AGE distribution; PSYCHOSES; SELF-injurious behavior; REGRESSION analysis; PUERPERIUM; DESCRIPTIVE statistics; PARITY (Obstetrics); RESEARCH funding; LONGITUDINAL method; MENTAL illness; PREGNANCY
- Subject Terms:
- Abstract: Background: Self-harm in pregnancy or the year after birth ('perinatal self-harm') is clinically important, yet prevalence rates, temporal trends and risk factors are unclear. Methods: A cohort study of 679 881 mothers (1 172 191 pregnancies) was conducted using Danish population register data-linkage. Hospital treatment for self-harm during pregnancy and the postnatal period (12 months after live delivery) were primary outcomes. Prevalence rates 1997–2015, in women with and without psychiatric history, were calculated. Cox regression was used to identify risk factors. Results: Prevalence rates of self-harm were, in pregnancy, 32.2 (95% CI 28.9–35.4)/100 000 deliveries and, postnatally, 63.3 (95% CI 58.8–67.9)/100 000 deliveries. Prevalence rates of perinatal self-harm in women without a psychiatric history remained stable but declined among women with a psychiatric history. Risk factors for perinatal self-harm: younger age, non-Danish birth, prior self-harm, psychiatric history and parental psychiatric history. Additional risk factors for postnatal self-harm: multiparity and preterm birth. Of psychiatric conditions, personality disorder was most strongly associated with pregnancy self-harm (aHR 3.15, 95% CI 1.68–5.89); psychosis was most strongly associated with postnatal self-harm (aHR 6.36, 95% CI 4.30–9.41). For psychiatric disorders, aHRs were higher postnatally, particularly for psychotic and mood disorders. Conclusions: Perinatal self-harm is more common in women with pre-existing psychiatric history and declined between 1997 and 2015, although not among women without pre-existing history. Our results suggest it may be a consequence of adversity and psychopathology, so preventative intervention research should consider both social and psychological determinants among women with and without psychiatric history. [ABSTRACT FROM AUTHOR]
- Abstract: Copyright of Psychological Medicine is the property of Cambridge University Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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