Perinatal depression and suicidal behaviour: the need for timely intervention

Authors

  • Ghanshyam Rathore Department of Obstetrics and Gynecology, M. M. College of Nursing, M. M. (Deemed to be) University, Mullana, Ambala, Haryana, India
  • Kanchan Sharma All India Institute of Medical Sciences, Jammu, Jammu and Kashmir, India
  • Nisha Yadav All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
  • Sujata Jha All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20250896

Keywords:

Perinatal depression, Suicidal behaviour, Timely intervention

Abstract

This review examines perinatal depression, including antenatal (pregnancy-related) and postnatal (after childbirth) depression. It highlights their prevalence, risk factors, symptoms, and impacts on women and families, such as premature birth and significant maternal mental health issues. Causes include environmental stressors, genetic predisposition, and hormonal changes. The review distinguishes between temporary "baby blues" and prolonged postnatal depression influenced by social, psychological, and biological factors. Risk factors include negative family dynamics, a history of mental health issues, and lack of social support. Emphasizing the need for timely intervention and comprehensive mental health care, this review used a comprehensive search strategy across databases like PubMed, Google Scholar, Scopus, and more. Keywords related to perinatal depression were used for screening abstracts and titles, with full-text articles assessed for eligibility. Quality was evaluated using tools like the Newcastle-Ottawa scale (NOS) and the critical appraisal skills programme (CASP). Findings highlight the importance of regular mental health screenings, psychotherapeutic approaches, pharmacological treatments, and robust support systems. Understanding the interactions between biological, psychological, and social factors in perinatal depression is crucial for improving maternal and fetal health outcomes.

Metrics

Metrics Loading ...

References

National Institute of Mental Health (NIMH). Perinatal Depression. Available at: https://www.nimh.nih.gov/health/publications/perinatal-depression. Accessed on 20 January 2025.

Muzik M, Borovska S. Perinatal depression: implications for child mental health. Ment Health Fam Med. 2010;7(4):239-47.

American Psychiatric Association. What is Perinatal Depression (formerly Postpartum)? Available at: https://www.psychiatry.org/patients-families/peripartum-depression/what-is-peripartum-depression. Accessed on 20 January 2025.

Mughal S, Azhar Y, Siddiqui W. Postpartum Depression. In: StatPearls. Treasure Island (FL): StatPearls Publishing. 2024.

Remes O, Mendes JF, Templeton P. Biological, Psychological, and Social Determinants of Depression: A Review of Recent Literature. Brain Sci. 2021;11(12):1633. DOI: https://doi.org/10.3390/brainsci11121633

Tirumalaraju V, Suchting R, Evans J, Goetzl L, Refuerzo J, Neumann A, et al. Risk of Depression in the Adolescent and Adult Offspring of Mothers With Perinatal Depression. JAMA Netw Open. 2020;3(6):e208783. DOI: https://doi.org/10.1001/jamanetworkopen.2020.8783

Silverman ME, Reichenberg A, Savitz DA, Cnattingius S, Lichtenstein P, Hultman CM, et al. The Risk Factors for Postpartum Depression: A Population Based Study. Depress Anxiety. 2017;34(2):178-87. DOI: https://doi.org/10.1002/da.22597

Cleveland Clinic. Advanced Maternal Age (Geriatric Pregnancy): Definition & Risks. Available at: https://my.clevelandclinic.org/health/diseases/22438-advanced-maternal-age. Accessed on 20 January 2025.

March of Dimes. Stress and pregnancy. Available at: https://www.marchofdimes.org/find-support/topics/pregnancy/stress-and-pregnancy. Accessed on 20 January 2025.

Torres AJC, Barbosa-Silva L, Oliveira-Silva LC, Miziara OPP, Guahy UCR, Fisher AN, et al. The Impact of Motherhood on Women’s Career Progression: A Scoping Review of Evidence-Based Interventions. Behav Sci. 2024;14(4):275. DOI: https://doi.org/10.3390/bs14040275

Biaggi A, Conroy S, Pawlby S, Pariante CM. Identifying the women at risk of antenatal anxiety and depression: A systematic review. J Affect Disord. 2016;191:62-77. DOI: https://doi.org/10.1016/j.jad.2015.11.014

Dunkel Schetter C, Tanner L. Anxiety, depression and stress in pregnancy: implications for mothers, children, research, and practice. Curr Opin Psychiatry. 2012;25(2):141-8. DOI: https://doi.org/10.1097/YCO.0b013e3283503680

Kleiman EM, Liu RT. Social support as a protective factor in suicide: Findings from two nationally representative samples. J Affect Disord. 2013;150(2):540-5. DOI: https://doi.org/10.1016/j.jad.2013.01.033

Arditi-Arbel B, Hamdan S, Winterman M, Gvion Y. Suicidal ideation and behavior among perinatal women and their association with sleep disturbances, medical conditions, and known risk factors. Front Psychiatry. 2023;13:987673. DOI: https://doi.org/10.3389/fpsyt.2022.987673

Wieczorek K, Targonskaya A, Maslowski K. Reproductive Hormones and Female Mental Wellbeing. Women. 2023;3(3):432-44. DOI: https://doi.org/10.3390/women3030033

Guan N, Guariglia A, Moore P, Xu F, Al-Janabi H. Financial stress and depression in adults: A systematic review. PLoS One. 2022;17(2):e0264041. DOI: https://doi.org/10.1371/journal.pone.0264041

Østergaard SD, Momen NC, Heide-Jørgensen U, Plana-Ripoll O. Risk of Suicide Across Medical Conditions and the Role of Prior Mental Disorder. JAMA Psychiatry. 2024;81(12):1198-206. DOI: https://doi.org/10.1001/jamapsychiatry.2024.2561

Barton K, Redshaw M, Quigley MA, Carson C. Unplanned pregnancy and subsequent psychological distress in partnered women: a cross-sectional study of the role of relationship quality and wider social support. BMC Pregnancy Childbirth. 2017;17(1):44. DOI: https://doi.org/10.1186/s12884-017-1223-x

Lynch FL, Peterson EL, Lu CY, Hu Y, Rossom RC, Waitzfelder BE, et al. Substance use disorders and risk of suicide in a general US population: a case control study. Addict Sci Clin Pract. 2020;15(1):14. DOI: https://doi.org/10.1186/s13722-020-0181-1

Reid HE, Pratt D, Edge D, Wittkowski A. Maternal Suicide Ideation and Behaviour During Pregnancy and the First Postpartum Year: A Systematic Review of Psychological and Psychosocial Risk Factors. Front Psychiatry. 2022;14:13. DOI: https://doi.org/10.3389/fpsyt.2022.765118

Legazpi PCC, Rodríguez-Muñoz MF, Olivares-Crespo ME, Izquierdo-Méndez N. Review of suicidal ideation during pregnancy: risk factors, prevalence, assessment instruments and consequences. Psicol Reflex E Crítica. 2022;35(1):13. DOI: https://doi.org/10.1186/s41155-022-00220-4

Izulla P, Muriuki A, Kiragu M, Yahner M, Fonner V, Nitu SNA, et al. Proximate and distant determinants of maternal and neonatal mortality in the postnatal period: A scoping review of data from low- and middle-income countries. PLoS One. 2023;18(11):e0293479. DOI: https://doi.org/10.1371/journal.pone.0293479

Chen Q, Li W, Xiong J, Zheng X. Prevalence and Risk Factors Associated with Postpartum Depression during the COVID-19 Pandemic: A Literature Review and Meta-Analysis. Int J Environ Res Public Health. 2022;19(4):2219. DOI: https://doi.org/10.3390/ijerph19042219

Goller HG, Byrd DP, Hicks AD, McCord DM. Detection of Psychological Dysfunction and Suicide Risk Among Postpartum Women. J Clin Psychol Med Settings. 2024;8. DOI: https://doi.org/10.1007/s10880-024-10028-2

Perry A, Gordon-Smith K, Jones L, Jones I. Phenomenology, Epidemiology and Aetiology of Postpartum Psychosis: A Review. Brain Sci. 2021;11(1):47. DOI: https://doi.org/10.3390/brainsci11010047

Gelabert E, Plaza A, Roca-Lecumberri A, Bramante A, Brenna V, Garcia-Esteve L, et al. Suicide Attempts during Pregnancy and Postpartum: A Systematic Review and Meta-Analysis. Matern Child Health J. 2024;28(9):1443-53. DOI: https://doi.org/10.1007/s10995-024-03956-w

White LK, Kornfield SL, Himes MM, Forkpa M, Waller R, Njoroge WFM, et al. The impact of postpartum social support on postpartum mental health outcomes during the COVID-19 pandemic. Arch Womens Ment Health. 2023;26(4):531-41. DOI: https://doi.org/10.1007/s00737-023-01330-3

Stack RJ, Meredith A. The Impact of Financial Hardship on Single Parents: An Exploration of the Journey From Social Distress to Seeking Help. J Fam Econ Issues. 2018;39(2):233-42. DOI: https://doi.org/10.1007/s10834-017-9551-6

Yoon J, Masoumirad M, Bui LN, Richard P, Harvey SM. Prenatal opioid use as a predictor of postpartum suicide attempts among reproductive-age women enrolled in Oregon Medicaid. BMC Womens Health. 2024;24(1):196. DOI: https://doi.org/10.1186/s12905-024-03019-w

Yu H, Shen Q, Bränn E, Yang Y, Oberg AS, Valdimarsdóttir UA, Lu D. Perinatal Depression and Risk of Suicidal Behavior. JAMA Netw Open. 2024;7(1):e2350897. DOI: https://doi.org/10.1001/jamanetworkopen.2023.50897

Clarke JR, Gibson M, Savaglio M, Navani R, Mousa M, Boyle JA. Digital screening for mental health in pregnancy and postpartum: A systematic review. Arch Womens Ment Health. 2024;27(4):489-526. DOI: https://doi.org/10.1007/s00737-024-01427-3

Dennis CL, Singla DR, Brown HK, Savel K, Clark CT, Grigoriadis S, et al. Postpartum Depression: A Clinical Review of Impact and Current Treatment Solutions. Drugs. 2024;84(6):645-59. DOI: https://doi.org/10.1007/s40265-024-02038-z

Simon GE, Moise N, Mohr DC. Management of Depression in Adults: A Review. JAMA. 2024;332(2):141-52. DOI: https://doi.org/10.1001/jama.2024.5756

World Health Organization. Depressive disorder (depression). Available at: https://www.who.int/news-room/fact-sheets/detail/depression. Accessed on 20 January 2025.

Gautam S, Jain A, Gautam M, Vahia VN, Grover S. Clinical Practice Guidelines for the management of Depression. Indian J Psychiatry. 2017;59(Suppl 1):S34-50. DOI: https://doi.org/10.4103/0019-5545.196973

Reid HE, Edge D, Pratt D, Wittkowski A. Working with suicidal mothers during the perinatal period: a reflexive thematic analysis study with mental health professionals. BMC Psychiatry. 2024;24(1):106. DOI: https://doi.org/10.1186/s12888-024-05537-1

McLeish J, Ayers S, McCourt C. Community-based perinatal mental health peer support: a realist review. BMC Pregnancy Childbirth. 2023;23(1):570. DOI: https://doi.org/10.1186/s12884-023-05843-8

Paris R, Bolton RE, Weinberg MK. Postpartum depression, suicidality, and mother-infant interactions. Arch Womens Ment Health. 2009;12(5):309-21. DOI: https://doi.org/10.1007/s00737-009-0105-2

Shiraly R, Jazayeri SA, Seifaei A, Jeihooni AK, Griffiths MD. Suicidal thoughts and behaviors among untreated illicit substance users: a population-based study. Harm Reduct J. 2024;21(1):96. DOI: https://doi.org/10.1186/s12954-024-01015-9

Daley D, McCauley M, van den Broek N. Interventions for women who report domestic violence during and after pregnancy in low- and middle-income countries: a systematic literature review. BMC Pregnancy Childbirth. 2020;20(1):141. DOI: https://doi.org/10.1186/s12884-020-2819-0

Kudrnáčová M, Kudrnáč A. Better sleep, better life? testing the role of sleep on quality of life. PloS One. 2023;18(3):e0282085. DOI: https://doi.org/10.1371/journal.pone.0282085

Moszeik EN, von Oertzen T, Renner KH. Effectiveness of a short Yoga Nidra meditation on stress, sleep, and well-being in a large and diverse sample. Curr Psychol. 2022;41(8):5272-86. Stentzel U, Grabe HJ, Schmidt S, Tomczyk S, van den Berg N, Beyer A. Mental health-related telemedicine interventions for pregnant women and new mothers: a systematic literature review. BMC Psychiatry. 2023;23:292. DOI: https://doi.org/10.1186/s12888-023-04790-0

Strand M, Eng LS, Gammon D. Combining online and offline peer support groups in community mental health care settings: a qualitative study of service users' experiences. Int J Ment Health Syst. 2020;14:39. DOI: https://doi.org/10.1186/s13033-020-00370-x

Pollack DL, Broudy CA, Coon TW, Franco DR. The holding space: An experiential–dynamic group therapy for mothers with postpartum anxiety and depression. Group Dyn Theory Res Pract. 2024;28(1):41-59. DOI: https://doi.org/10.1037/gdn0000205

Edinoff AN, Odisho AS, Lewis K, Kaskas A, Hunt G, Cornett EM, et al. Brexanolone, a GABAA Modulator, in the Treatment of Postpartum Depression in Adults: A Comprehensive Review. Front Psychiatry. 2021;12:699740. DOI: https://doi.org/10.3389/fpsyt.2021.699740

Jobes DA, Au JS, Siegelman A. Psychological Approaches to Suicide Treatment and Prevention. Curr Treat Options Psychiatry. 2015;2(4):363-70. DOI: https://doi.org/10.1007/s40501-015-0064-3

Al Dweik R, Ajaj R, Kotb R, Halabi DE, Sadier NS, Sarsour H, et al. Opportunities and challenges in leveraging digital technology for mental health system strengthening: a systematic review to inform interventions in the United Arab Emirates. BMC Public Health. 2024;24(1):2592. DOI: https://doi.org/10.1186/s12889-024-19980-y

Hawgood J, Woodward A, Quinnett P, De Leo D. Gatekeeper Training and Minimum Standards of Competency. Crisis. 2022;43(6):516-22. DOI: https://doi.org/10.1027/0227-5910/a000794

Bryan CJ, Stone SL, Rudd MD. A practical, evidence-based approach for means-restriction counseling with suicidal patients. Prof Psychol Res Pract. 2011;42(5):339-46. DOI: https://doi.org/10.1037/a0025051

Downloads

Published

2025-03-27

How to Cite

Rathore, G., Sharma, K., Yadav, N., & Jha, S. (2025). Perinatal depression and suicidal behaviour: the need for timely intervention. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 14(4), 1378–1386. https://doi.org/10.18203/2320-1770.ijrcog20250896

Issue

Section

Review Articles