Interventions to reduce perinatal suicidality: a global systematic review

AI Summary

Few studies assess perinatal suicidality as a primary or secondary outcome, limiting evidence on effective interventions.
Some health system and psychological interventions, including multidisciplinary community programmes and behavioural activation, reduced suicidality in some trials.
Many studies were underpowered or recorded suicidality only for safety monitoring, so robust trials targeted at suicidality are needed.

J Reprod Infant Psychol. 2026 Nov 14:1-18. doi: 10.1080/02646838.2026.2757842. Online ahead of print.

ABSTRACT

INTRODUCTION: Perinatal suicidality (suicidal thoughts, behaviours, plans and attempts) is a risk factor for suicide. Evidence on interventions to reduce perinatal suicidality remains limited. This systematic review examined the effectiveness of non-pharmacological interventions to reduce suicidality in perinatal women.

METHODS: This review was registered with PROSPERO (CRD420251081528). Seven databases were searched from 2010 to December 2025. Interventions assessing a reduction in perinatal suicidality as a primary, secondary, or safety monitoring outcome were included. Two reviewers independently screened articles. A narrative summary was compiled. Risk of bias was assessed using the Mixed Methods Appraisal Tool.

RESULTS: Six studies were included: 5 randomised controlled trials (3 individually randomised, 1 cluster, 1 noninferiority) and 1 historical controlled trial. Three studies investigated suicidality as a primary or secondary outcome, and three studies collected suicidality data for safety monitoring. Of these, two investigated multidisciplinary community health programmes, and one evaluated a behavioural activation therapy. Two studies showed a reduction in suicidality, and one showed a significant reduction at 3-4 months postpartum, but not at 7-8 months. Three studies assessed suicidality as safety monitoring. These studies investigated eye movement desensitisation and reprocessing therapy, a practice-level intervention incorporated into obstetric practices, and an electronic mindfulness-based intervention. These studies were not adequately powered to assess a reduction in suicidality.

DISCUSSION: Few studies have investigated suicidality as a primary or secondary outcome. Although some health system level and psychological interventions were associated with a reduction in suicidality, robust evidence from interventions specifically designed to reduce perinatal suicidality is needed.

PMID:43033196 | DOI:10.1080/02646838.2026.2757842

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