Article

Injury deaths, suicides and homicides associated to pregnancy, Finland 1987-2000

Tulane University, New Orleans, Louisiana, United States
The European Journal of Public Health (Impact Factor: 2.46). 11/2005; 15(5):459-63. DOI: 10.1093/eurpub/cki042
Source: PubMed

ABSTRACT Only few studies have been carried out on the relationship between pregnancy and deaths from external causes.
Information on deaths from external causes among women aged 15-49 years in Finland in 1987-2000 (n = 5299) was linked to three national health registers to identify pregnancy-associated deaths (n = 212).
The mortality rate for women during pregnancy and within 1 year of pregnancy termination from external causes was lower than mortality from external causes among non-pregnant women (relative risk 0.79; 95% confidence interval 0.69-0.91). Owing to elevated suicide and homicide rates, however, an increased risk was observed for women after abortions, especially in the age group of 15-24 years.
The low rate of deaths from external causes suggests the protective effect of childbirth, but the elevated risk after a terminated pregnancy needs to be recognized in the provision of health care and social services.

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    • "Suicidal behavior and suicide rates may be increased after an abortion, particularly when induced [79, 80]. In fact, induced abortion may increase suicidal risk in relation with the impact of the decision itself, because prior to the abortion no difference in suicidal risk was found with women completing their pregnancy [81]. "
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    ABSTRACT: It is nowadays accepted that, independently of methodological issues, women commit fewer suicides than men but make more frequent attempts. Yet, female suicidal risk varies greatly along the lifetime and is linked to the most significant moments in it. A wide analysis of the existing literature was performed to provide a narrative description on the evolution of female suicidal rates from childhood to old age, considering the milestones in their life history. A detailed analysis of gender differences in suicidal behavior is key to establish preventive measures and priorities. More specific studies are needed to adapt future interventions on female suicide.
    The Scientific World Journal 02/2013; 2013:485851. DOI:10.1155/2013/485851 · 1.73 Impact Factor
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    • "We examine clinically diagnosed major depression, suicidal ideation, and self-esteem. Some research has examined whether women who have an abortion are at an increased risk of subsequent depressive symptoms or disorders (e.g., Coleman et al., 2009; Reardon & Cougle, 2002; Russo & Denious, 2001; Schmiege & Russo, 2005; Taft & Watson, 2008; Pederson, 2008), having suicidal ideation or committing suicide (e.g., Fergusson et al., 2006, 2008; Gissler et al., 1996, 1997, 2004a, 2004b, 2005; Reardon et al., 2002), or lower self esteem (e.g., Bradshaw & Slade, 2003; Pope, Adler, & Tschann, 1999; Russo & Dabul, 1997; Russo & Zierk, 1992). Findings have varied depending on the outcome examined, the measurement of the outcome, the comparison group used, and what factors were controlled in the analyses. "
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    ABSTRACT: This study examines the risk of depression, suicidal ideation, and lower self-esteem following an abortion versus a delivery, with and without adjusting for important correlates. Using the National Comorbidity Survey, we tested how first pregnancy outcome (abortion vs. delivery) related to subsequent major depression, suicidal ideation, and self-esteem. Models controlling for risk factors, such as background and economic factors, prepregnancy violence experience, and prepregnancy mental health, as well as a model with all risk factors, were examined. When no risk factors were entered in the model, women who had abortions were more likely to have subsequent depression, OR=1.53, 95% CI [1.05-2.22], and suicidal ideation, OR=2.02, 95% CI [1.40-2.92], but they were not more likely to have lower self-esteem, B=-.02. When all risk factors were entered, pregnancy outcome was not significantly related to later depression, OR=0.87, 95% CI [0.54-1.37], and suicidal ideation, OR=1.19, 95% CI [0.70-2.02]. Predictors of mental health following abortion and delivery included prepregnancy depression, suicidal ideation, and sexual violence. Policies and practices implemented in response to the claim that abortion hurts women are not supported by our findings. Efforts to support women's mental health should focus on known risk factors, such as gender-based violence and prior mental health problems, rather than abortion history.
    American Journal of Orthopsychiatry 04/2011; 81(2):193-201. DOI:10.1111/j.1939-0025.2011.01088.x · 1.50 Impact Factor
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    • "Information on pre-existing mental health status has seldom been available, even though it has been shown to be an important explanatory factor for the increased risk for negative mental health outcomes in several [7,14], though not in all studies [16]. Since induced abortion and mental health problems share same risk factors - such as young age [12], poor socioeconomic circumstances, violence [3,7], and rape history [7] - the causality between induced abortion and subsequent mental health problems cannot be straightforwardly concluded without taking into consideration their common determinants. "
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    ABSTRACT: Some, though not all studies have reported an increased risk for mental health problems after an induced abortion. Problems with design and data have compromised these studies and the generalisation of their results. The Finnish Medication and Pregnancy database (N = 622 671 births and 114 518 induced abortions for other than fetal reasons) in 1996-2006 was utilised to study the use of psychotropic drugs in the three months before a pregnancy ending in a birth or an induced abortion. In total 2.1% of women with a birth and 5.1% of women with an induced abortion had used a psychotropic medicine 0-3 months before pregnancy. Psychotropic drug users terminated their pregnancies (30.9%) more often than other pregnant women (15.5%). Adjustment for background characteristics explained one third of this elevated risk, but the risk remained significantly increased among users of psychotropic medicine (OR 1.94, 95% confidence intervals 1.87-2.02). A similar risk was found for first pregnancies (30.1% vs. 18.9%; adjusted OR 1.53, 95% confidence intervals 1.42-1.65). The rate for terminating pregnancy was the highest for women using hypnotics and sedatives (35.6% for all pregnancies and 29.1% for first pregnancies), followed by antipsychotics (33.9% and 36.0%) and antidepressants (32.0% and 32.1%). The observed increased risk for induced abortion among women with psychotropic medication highlights the importance to acknowledge the mental health needs of women seeking an induced abortion. Further studies are needed to establish the impact of pre-existing differences in mental health on mental health outcomes of induced abortions compared to outcomes of pregnancies ending in a birth.
    BMC Public Health 06/2010; 10(1):383. DOI:10.1186/1471-2458-10-383 · 2.32 Impact Factor
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