We’ve known for awhile that perinatal depression (which encompasses both postpartum depression/PPD and depression during pregnancy) is linked to a higher risk of suicide in mothers, but a pair of high-impact studies just released have shown that this heightened risk of suicidal behavior and early death remains up to 𝟏𝟖 𝐘𝐄𝐀𝐑𝐒 𝐋𝐀𝐓𝐄𝐑.
Yu et al. (2024) found that mothers with perinatal depression were at higher risk for suicidal behavior that led to hospitalization, and while this risk was highest directly following diagnosis (~7x higher than those without perinatal depression), the risk was still more than double up to 18 years later.
• Of note, having no history of psychiatric disorders BEFORE a PPD diagnosis was tied to a higher risk of suicidal behavior (3.63x higher) than for women with a history of depression (2.52x higher) or history other psychiatric disorders (2.47x higher).
• The authors did a secondary analysis where they used sisters who had babies during the same study period, and found that while it attenuated the risk a little, it was still significantly higher (still in the 2.75x - 2.94x range), stronger evidence that the PPD itself imparts this future risk and not, say, a history of childhood abuse.
Hagatulah et al. (2024) found women with perinatal depression had an almost 3-fold increased risk of mortality in the years following their diagnosis, one that remained over a 2-fold increase in risk up to 18 years later. Similar to the first study, PPD was tied to a higher hazard ratio than antenatal depression diagnoses.
• As the NYT article pointed out, "The number of suicides was small, but it accounted for a large share of the deaths of women diagnosed with perinatal depression: 149 of the 522 deaths in that group, or 28.5 percent. For women without perinatal depression, there were 117 suicides out of 1,568 deaths or 7.5 percent."
• Women with PPD were 6.34x more likely to die by suicide than those without it.
We now know that perinatal depression imparts a lingering risk of suicidal behavior or early death relative to women who don’t experience it, thanks to this high-quality research.
When will there be enough evidence of the damage caused by not treating these disorders for policy to change in the US? For health systems to change to better address it?
This is why we focus on maternal mental health at Mavida Health, and why we’ll keep pushing for better mental health care during this pivotal life transition.
(I’ll post some bigger takeaways in the comments, as well as links to all these articles!)