- Self-harm ideation affected 2.3% of pregnant and 1.1% of postpartum women, as reported via the EPDS self-harm item.
- Depressive symptom severity was the strongest independent risk factor in both pregnancy and postpartum (ORs 1.27 and 1.32 respectively).
- Recommend routine screening with explicit self-harm questions throughout pregnancy and the first postpartum year, combined with socioeconomic assessment to improve identification.
Dialogues Clin Neurosci. 2026 Dec;28(1):314-326. doi: 10.1080/19585969.2026.2719514. Epub 2026 Aug 24.
ABSTRACT
INTRODUCTION: The perinatal period is marked by heightened vulnerability to mental health difficulties, including the onset of self-harm ideation (SHI). We aimed to (a) estimate the prevalence of self-harm ideation among perinatal women, (b) explore sociodemographic, clinical, and psychosocial correlates of SHI.
METHODS: This is a cross-sectional study involving pregnant (n = 5,087) and postpartum women (n = 6,550). SHI was measured using item 10 of the Edinburgh Postnatal Depression Scale (EPDS), depressive symptoms using the remaining 9 EPDS items (EPDS-9), and anxiety symptoms using the Generalised Anxiety Disorder-7. Prespecified multivariable logistic models were fitted separately for pregnancy and postpartum.
RESULTS: SHI prevalence was 2.3% during pregnancy and 1.1% postpartum. In pregnancy, risk was independently associated with depressive symptom severity (OR = 1.27, 95%CI [1.21-1.33], p<.001) and immigrant status (OR = 2.08, 95%CI [1.15-3.75], p=.015), whereas better economic conditions were protective (OR = 0.53 per category increase, 95%CI [0.36-0.78], p=.001). In the postpartum period, depressive symptoms remained strongly associated with SHI (OR = 1.32, 95%CI [1.24-1.40], p<.001), and stable paid employment was protective (OR = 0.41, 95%CI [0.23-0.74], p=.003). Phase-specific models showed good to excellent discrimination (AUCpregnancy=.86; AUCpostpartum=.91) and acceptable calibration. No clinically meaningful EPDS-9 × phase interaction emerged.
CONCLUSIONS: A portion of perinatal women experience SHI and report it when asked directly (i.e. through the EPDS self-harm item). Routine screening should include explicit questions about self-harm thoughts and should continue through the first postpartum year. Combining mood screening with assessment of socioeconomic adversity may further improve the identification of individuals who could benefit from additional support.
PMID:42636039 | DOI:10.1080/19585969.2026.2719514
Share Evidence Blueprint
Save to Google Notes
Search Google Scholar
Save as PDF
⭐ My Revision List
