Obsetric Care and Suicide in Adult Men
Obstetric care and proneness of offspring to suicide as
adults: case-control study
Bertil Jacobson, professor emeritus
Marc Bygdeman, professor
BMJ 1998;317:1346-1349 ( 14 November )
To investigate any long term effects of
traumatic birth and obstetric procedures in relation
to suicide by violent means in offspring as adults.
Prospective case-control study.
242 adults who committed suicide by violent means from 1978 to 1995, and who
were born in one of seven hospitals in Stockholm during 1945-80, matched with
403 biological siblings born during the same period and at the same group of
Main outcome measures
Adverse and beneficial perinatal factors expressed as relative risks
(odds ratios) and 95% confidence intervals, derived from logistic regression
of cases matched with their siblings.
For multiple birth trauma the estimated relative risks of offspring subsequently
committing suicide by violent means were 4.9 (95% confidence interval 1.8 to 13)
for men and 1.04 (0.2 to 4.6) for women. In mothers who received multiple opiate
treatment during delivery, the estimated relative risk of offspring subsequently
committing suicide was equal for both sexes (0.26, 0.09 to 0.69).
Minimising pain and discomfort to the infant during birth seems to be of
importance in reducing the risk of committing suicide by violent means as an adult.
- Adverse perinatal conditions are associated with an increased risk of suicide by
violent means for adult men
- Giving opiates to the mother during delivery was associated with a decreased
risk of subsequent suicide by violent means in offspring
- Similar studies of accident proneness as well as suicides by violent means are
required possibly to corroborate the findings
- Obstetric procedures should be chosen that reduce perinatal trauma to minimise
the possible risk for subsequent adult self destructive behaviour