Suicide Risk associated with Pre- and Postnatal and Early Childhood Factors
Dec 1, 2006 - 5:16:23 PM
Low birth weight, having one or more older siblings, a young mother and parents with non-professional jobs are all independent risk factors for higher suicide risk in later life, according to a new study.
Published in the December issue of the British Journal of Psychiatry, the research used Scottish birth and death records to examine the relationship between pre- and postnatal circumstances and subsequent young adult suicide.
Information was analysed on 1,061,830 people born between 1969 and 1986 for whom an electronic Scottish Morbidity Record was available. This included anonymised data on birth weight, gestational age at birth, maternal age, number of elder children in the family and parental occupations.
These records were linked to the register of Scottish deaths, and people who died between 1981 and 2003 by suicide (death by self-inflicted injury or undetermined death) were identified.
Self-inflicted injury was recorded as the cause of death in 1053 cases, and undetermined death in 411, so that 1464 cases were identified as suicide. 1166 of these were male and 298 female.
A significant association was found between offspring suicide (and death from other causes) and whether the mother already had children.
People born to women aged 24 or younger were at significantly greater risk of subsequent suicide (and death from other causes) compared to those with older mothers. The risk of offspring suicide was higher among those born to women aged 19 or under.
Low birth weight (less than 2500g) raised the risk of later suicide, as well as death from other causes. However, no significant association was found between gestational age at birth and later suicide, suggesting that premature birth is not a risk factor for suicide.
Compared with parents in professional occupations, children of parents in skilled occupations and unskilled occupations were more likely to have died by suicide.
The authors of the study comment that it is the first to show an association between how many children a woman has and later offspring completed suicide. This risk was significantly higher even in those born to mothers who had just one completed pregnancy.
Suicide is strongly correlated with mental disorders, and there is a well-documented link between mental disorder and an increased risk of premature death, not only from suicide, but also from other causes. The findings of this study on the effects of already having children, and maternal age, would be consistent with the idea that these factors affect susceptibility to mental illness.
Theoretically, it is possible that mothers experience greater stress during pregnancy if they are teenagers, have an older child to care for, or are financially disadvantaged. The results of this study are consistent with the maternal-foetal origins hypothesis of the causes of mental illness, which suggests that maternal stress has a negative influence on foetal brain development.
Further research is needed to clarify how the risk factors identified in this study operate. They may be influencing attachment processes, altering gene expression through antenatal maternal stress, or directly increasing stress and stress hormone levels in the infant or young child.
It needs to be established to what extent the pre- and postnatal risk factors are associated with mental illness in general, and how they influence causes of death other than suicide.
Many initiatives aimed at tackling youth suicide focus on the current environment of young adults. The results of this study suggest that paying attention to early childhood, even antenatal environments, may have an impact on suicide rates in years to come.
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