Perinatal adversity profiles and suicide attempt in adolescence and young adulthood: Longitudinal analyses from two 20-year birth cohort studies

Orri Massimiliano; Abigail Emma Russell; Becky Mars; Gustavo Turecki; David J Gunnell; Jon E Heron; Richard Tremblay; Michel Boivin; Anne-Monique Nuyt; Sylvana M Côté; Marie-Claude Geoffroy

doi:10.1017/S0033291720002974

Perinatal adversity profiles and suicide attempt in adolescence and young adulthood: Longitudinal analyses from two 20-year birth cohort studies

Orri Massimiliano, Abigail Emma Russell, Becky Mars, Gustavo Turecki, David J Gunnell, Jon E Heron, Richard Tremblay, Michel Boivin, Anne-Monique Nuyt, Sylvana M Côté, Marie-Claude Geoffroy ^*

^*Corresponding author for this work

Research output: Contribution to journal › Article (Academic Journal) › peer-review

10 Citations (Scopus)

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Abstract

Background.
We aimed to identify groups of children presenting distinct perinatal adversity profiles and test the association between profiles and later risk of suicide attempt.

Methods.
Data were from the Québec Longitudinal Study of Child Development (QLSCD, N=1623), and the Avon Longitudinal Study of Parents and Children (ALSPAC, N=5734). Exposures to 32 perinatal adversities (eg, fetal, obstetric, psychosocial, and parental psychopathology) were modeled using latent class analysis, and associations with self-reported suicide attempt by age 20 were investigated with logistic regression. We investigated to what extent childhood emotional and behavioral problems, victimization, and cognition explained the associations.

Results.
In both cohorts, we identified 5 profiles: No perinatal risk, Poor fetal growth, Socioeconomic adversity, Delivery complications, Parental mental health problems (ALSPAC only). Compared to children with No perinatal risk, children in the Poor fetal growth (pooled estimate QLSCD-ALSPAC, OR=1.89, 95%CI=1.04-3.44), Socioeconomic adversity (pooled-OR=1.42, 95%CI=1.08-1.85), and Parental mental health problems (OR=1.74, 95%CI=1.27-2.40), but not Delivery complications, profiles were more likely to attempt suicide. The proportion of this effect mediated by the putative mediators was larger for the Socioeconomic adversity profile compared to the others.

Conclusions.
Perinatal adversities associated with suicide attempt cluster in distinct profiles. Suicide prevention may begin early in life and requires a multidisciplinary approach targeting a constellation of factors from different domains (psychiatric, obstetric, socioeconomic), rather than a single factor, to effectively reduce suicide vulnerability. The way these factors cluster together also determined the pathways leading to suicide attempt, which can guide decision-making on personalized suicide prevention strategies.

Original language	English
Pages (from-to)	1 - 13
Journal	Psychological Medicine
Early online date	6 Oct 2020
DOIs	https://doi.org/10.1017/S0033291720002974
Publication status	E-pub ahead of print - 6 Oct 2020

Structured keywords

ALSPAC
SASH

Keywords

ALSPAC
latent class analysis
perinatal adversity
QLSCD
suicide attempt

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1017/S0033291720002974

Full-text PDF (author accepted manuscript)
This is the author accepted manuscript (AAM). The final published version (version of record) is available online via Cambridge University Press at https://doi.org/10.1017/S0033291720002974 . Please refer to any applicable terms of use of the publisher.
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PATHWAYS TO SELF-HARM: BIOLOGICAL MECHANISMS AND GENETIC CONTRIBUTION
Mars, B.
1/10/17 → 31/05/20
Project: Research

Dr Becky Mars
- Becky.Marsbristol.acuk
- Bristol Medical School (PHS) - Associate Professor in Epidemiology
- Bristol Population Health Science Institute
- Bristol Neuroscience
Person: Academic , Member

Cite this

Massimiliano, O., Emma Russell, A., Mars, B., Turecki, G., Gunnell, D. J., Heron, J. E., Tremblay, R., Boivin, M., Nuyt, A.-M., Côté, S. M., & Geoffroy , M.-C. (2020). Perinatal adversity profiles and suicide attempt in adolescence and young adulthood: Longitudinal analyses from two 20-year birth cohort studies. Psychological Medicine, 1 - 13. Advance online publication. https://doi.org/10.1017/S0033291720002974

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title = "Perinatal adversity profiles and suicide attempt in adolescence and young adulthood: Longitudinal analyses from two 20-year birth cohort studies",

abstract = "Background. We aimed to identify groups of children presenting distinct perinatal adversity profiles and test the association between profiles and later risk of suicide attempt.Methods. Data were from the Qu{\'e}bec Longitudinal Study of Child Development (QLSCD, N=1623), and the Avon Longitudinal Study of Parents and Children (ALSPAC, N=5734). Exposures to 32 perinatal adversities (eg, fetal, obstetric, psychosocial, and parental psychopathology) were modeled using latent class analysis, and associations with self-reported suicide attempt by age 20 were investigated with logistic regression. We investigated to what extent childhood emotional and behavioral problems, victimization, and cognition explained the associations.Results. In both cohorts, we identified 5 profiles: No perinatal risk, Poor fetal growth, Socioeconomic adversity, Delivery complications, Parental mental health problems (ALSPAC only). Compared to children with No perinatal risk, children in the Poor fetal growth (pooled estimate QLSCD-ALSPAC, OR=1.89, 95%CI=1.04-3.44), Socioeconomic adversity (pooled-OR=1.42, 95%CI=1.08-1.85), and Parental mental health problems (OR=1.74, 95%CI=1.27-2.40), but not Delivery complications, profiles were more likely to attempt suicide. The proportion of this effect mediated by the putative mediators was larger for the Socioeconomic adversity profile compared to the others.Conclusions. Perinatal adversities associated with suicide attempt cluster in distinct profiles. Suicide prevention may begin early in life and requires a multidisciplinary approach targeting a constellation of factors from different domains (psychiatric, obstetric, socioeconomic), rather than a single factor, to effectively reduce suicide vulnerability. The way these factors cluster together also determined the pathways leading to suicide attempt, which can guide decision-making on personalized suicide prevention strategies.",

keywords = "ALSPAC, latent class analysis, perinatal adversity, QLSCD, suicide attempt",

author = "Orri Massimiliano and {Emma Russell}, Abigail and Becky Mars and Gustavo Turecki and Gunnell, {David J} and Heron, {Jon E} and Richard Tremblay and Michel Boivin and Anne-Monique Nuyt and C{\^o}t{\'e}, {Sylvana M} and Marie-Claude Geoffroy",

year = "2020",

month = oct,

day = "6",

doi = "10.1017/S0033291720002974",

language = "English",

pages = "1 -- 13",

journal = "Psychological Medicine",

issn = "0033-2917",

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Massimiliano, O, Emma Russell, A, Mars, B, Turecki, G, Gunnell, DJ, Heron, JE, Tremblay, R, Boivin, M, Nuyt, A-M, Côté, SM & Geoffroy , M-C 2020, 'Perinatal adversity profiles and suicide attempt in adolescence and young adulthood: Longitudinal analyses from two 20-year birth cohort studies', Psychological Medicine, pp. 1 - 13. https://doi.org/10.1017/S0033291720002974

TY - JOUR

T1 - Perinatal adversity profiles and suicide attempt in adolescence and young adulthood

T2 - Longitudinal analyses from two 20-year birth cohort studies

AU - Massimiliano, Orri

AU - Emma Russell, Abigail

AU - Mars, Becky

AU - Turecki, Gustavo

AU - Gunnell, David J

AU - Heron, Jon E

AU - Tremblay, Richard

AU - Boivin, Michel

AU - Nuyt, Anne-Monique

AU - Côté, Sylvana M

AU - Geoffroy , Marie-Claude

PY - 2020/10/6

Y1 - 2020/10/6

N2 - Background. We aimed to identify groups of children presenting distinct perinatal adversity profiles and test the association between profiles and later risk of suicide attempt.Methods. Data were from the Québec Longitudinal Study of Child Development (QLSCD, N=1623), and the Avon Longitudinal Study of Parents and Children (ALSPAC, N=5734). Exposures to 32 perinatal adversities (eg, fetal, obstetric, psychosocial, and parental psychopathology) were modeled using latent class analysis, and associations with self-reported suicide attempt by age 20 were investigated with logistic regression. We investigated to what extent childhood emotional and behavioral problems, victimization, and cognition explained the associations.Results. In both cohorts, we identified 5 profiles: No perinatal risk, Poor fetal growth, Socioeconomic adversity, Delivery complications, Parental mental health problems (ALSPAC only). Compared to children with No perinatal risk, children in the Poor fetal growth (pooled estimate QLSCD-ALSPAC, OR=1.89, 95%CI=1.04-3.44), Socioeconomic adversity (pooled-OR=1.42, 95%CI=1.08-1.85), and Parental mental health problems (OR=1.74, 95%CI=1.27-2.40), but not Delivery complications, profiles were more likely to attempt suicide. The proportion of this effect mediated by the putative mediators was larger for the Socioeconomic adversity profile compared to the others.Conclusions. Perinatal adversities associated with suicide attempt cluster in distinct profiles. Suicide prevention may begin early in life and requires a multidisciplinary approach targeting a constellation of factors from different domains (psychiatric, obstetric, socioeconomic), rather than a single factor, to effectively reduce suicide vulnerability. The way these factors cluster together also determined the pathways leading to suicide attempt, which can guide decision-making on personalized suicide prevention strategies.

AB - Background. We aimed to identify groups of children presenting distinct perinatal adversity profiles and test the association between profiles and later risk of suicide attempt.Methods. Data were from the Québec Longitudinal Study of Child Development (QLSCD, N=1623), and the Avon Longitudinal Study of Parents and Children (ALSPAC, N=5734). Exposures to 32 perinatal adversities (eg, fetal, obstetric, psychosocial, and parental psychopathology) were modeled using latent class analysis, and associations with self-reported suicide attempt by age 20 were investigated with logistic regression. We investigated to what extent childhood emotional and behavioral problems, victimization, and cognition explained the associations.Results. In both cohorts, we identified 5 profiles: No perinatal risk, Poor fetal growth, Socioeconomic adversity, Delivery complications, Parental mental health problems (ALSPAC only). Compared to children with No perinatal risk, children in the Poor fetal growth (pooled estimate QLSCD-ALSPAC, OR=1.89, 95%CI=1.04-3.44), Socioeconomic adversity (pooled-OR=1.42, 95%CI=1.08-1.85), and Parental mental health problems (OR=1.74, 95%CI=1.27-2.40), but not Delivery complications, profiles were more likely to attempt suicide. The proportion of this effect mediated by the putative mediators was larger for the Socioeconomic adversity profile compared to the others.Conclusions. Perinatal adversities associated with suicide attempt cluster in distinct profiles. Suicide prevention may begin early in life and requires a multidisciplinary approach targeting a constellation of factors from different domains (psychiatric, obstetric, socioeconomic), rather than a single factor, to effectively reduce suicide vulnerability. The way these factors cluster together also determined the pathways leading to suicide attempt, which can guide decision-making on personalized suicide prevention strategies.

KW - ALSPAC

KW - latent class analysis

KW - perinatal adversity

KW - QLSCD

KW - suicide attempt

U2 - 10.1017/S0033291720002974

DO - 10.1017/S0033291720002974

M3 - Article (Academic Journal)

C2 - 33019954

SN - 0033-2917

SP - 1

EP - 13

JO - Psychological Medicine

JF - Psychological Medicine

ER -

Perinatal adversity profiles and suicide attempt in adolescence and young adulthood: Longitudinal analyses from two 20-year birth cohort studies

Abstract

Structured keywords

Keywords

UN SDGs

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Projects

PATHWAYS TO SELF-HARM: BIOLOGICAL MECHANISMS AND GENETIC CONTRIBUTION

Profiles

Dr Becky Mars

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