#64 Suicide and suicide attempts among women in the Manitoba Mothers and Fetal Alcohol Spectrum Disorder cohort: a retrospective matched analysis using linked administrative data
Deepa Singal, Manitoba Centre for Health Policy; Marni Brownell, Manitoba Centre for Health Policy; Dan Chateau, Manitoba Centre for Health Policy; Elizabeth Wall-Wieler, Manitoba Centre for Health Policy; Sally Longestaffe, University of Manitoba; Ana Hanlon-Dearman, University of Manitoba; Leslie L Roos, Manitoba Centre for Health Policy
Women who give birth to children with FASD may be at increased risk for suicide, however there are few data in this area. The objective of this study was to compare rates of suicide between women who had given birth to children with FASD and women who had not given birth to children with FASD during critical time periods in their lives, including before pregnancy, during pregnancy, during the postpartum period, and until the end of the study period.
We conducted a retrospective cohort analysis of all children born in Manitoba between April 1, 1984 and March 31, 2012 who had an FASD diagnosis from April 1st, 1999 to March 31st 2012, with follow-up till December 1, 2013 (study group; n=702). We generated a comparison group of women (n=2097) matched 1:3 on date of birth of index child, region of residence, and socioeconomic status (SES). We used linked administrative data to investigate suicide attempt and completion rates. Regression modeling produced relative rates (RRs) adjusted for SES, and maternal age at birth and was used to assess suicide risk.
The 2,799 participants produced 40,390.21 person-years till the end of the study period. Rates were higher among the study group for suicide completion (adjusted RR 6.49, 95% confidence interval (CI) 2.48-16.93), number of women attempting suicide (adjusted RR 5.27, 95% CI 2.88-9.66) and number of attempts after the birth of the child till the end of the study period (adjusted RR 3.87, 95% CI 2.33-6.46).
This study identifies a group of women with increased rates of social complexities, mental disorders and alcohol use that places them at risk for suicide. Interventions are needed that screen for suicidal behaviour in women who are at high risk to consume alcohol during pregnancy and have mental disorders.