(718) Identification of Black Birthing People at Highest Risk for Suicide

Suicide is one of the leading contributors to maternal mortality, however prediction of perinatal suicide remains poor. A history of prior suicide attempt is considered one of the most robust predictors of eventually completed suicide. We aimed to evaluate whether social determinants of mental health (SDoMH) can correctly classify birthing people at the highest risk of perinatal suicide.

Study Design:

This secondary analysis of a prospective cohort of Black birthing people. Individuals in the primary study were included in this analysis if they completed the Philadelphia ACE screen, which queried any prior history of attempted suicide. SDoMH, including age at pregnancy, parity, body mass index, ethnicity, insurance, marital status, and educational attainment, was obtained through self-report. Bivariable and multivariable models were used to identify SDoMH associated with a prior suicide attempt. A receiver operating characteristic curve for the outcome of prior suicide attempt was generated and the area under the curve (AUC) calculated.

Results:

Of the 592 Black birthing people included in the parent cohort, 487 (82%) met eligibility criteria. Forty-six people (9.5%) reported a history of a prior attempted suicide. In bivariable and multivariable analyses, none of the evaluated SDoMH were significantly associated with a history of attempted suicide (Table). SDoMH were unable to accurately classify which individuals had a prior history of suicide attempt (AUC 0.62, 95% CI 0.52-0.72).

Conclusion: Nearly one in ten Black birthing people in this cohort previously attempted suicide. While SDoMH have been implicated as risk factors for suicide in the general population, these determinants were not associated with a history of a suicide attempt in this perinatal cohort. These data demonstrate persistent gaps in our capacity to correctly identify birthing people at highest risk of suicide.