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 journalArticle (Academic Journal)peer-review

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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 languageEnglish
Pages (from-to)1 - 13
JournalPsychological Medicine
Early online date6 Oct 2020
DOIs
Publication statusE-pub ahead of print - 6 Oct 2020

Keywords

  • ALSPAC
  • latent class analysis
  • perinatal adversity
  • QLSCD
  • suicide attempt

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