Archives of Women's Mental Health

, Volume 22, Issue 1, pp 65–73 | Cite as

Suicide risk assessment: examining transitions in suicidal behaviors among pregnant women in Perú

  • Elizabeth J. LeveyEmail author
  • Marta B. Rondon
  • Sixto Sanchez
  • Qiu-Yue Zhong
  • Michelle A. Williams
  • Bizu Gelaye
Original Article


The goals of this research were to characterize suicidal behavior among a cohort of pregnant Peruvian women and identify risk factors for transitions between behaviors. The World Health Organization Composite International Diagnostic Interview suicide questionnaire was employed to assess suicidal behavior. Discrete-time survival analysis was used to study the cumulative age-of-onset distribution. The hazard function was calculated to assess the risk of onset of each suicidal behavior. Among 2062 participants, suicidal behaviors were endorsed by 22.6% of participants; 22.4% reported a lifetime history of suicidal ideation, 7.2% reported a history of planning, and 6.0% reported attempting suicide. Childhood abuse was most strongly associated with suicidal behavior, accounting for a 2.57-fold increased odds of suicidal ideation, nearly 3-fold increased odds of suicide planning, and 2.43-fold increased odds of suicide attempt. This study identified the highest prevalence of suicidal behavior in a population of pregnant women outside the USA. Diverse populations of pregnant women and their patterns of suicidal behavior transition must be further studied. The association between trauma and suicidal behavior indicates the importance of trauma-informed care for pregnant women.


Peru Pregnant Risk assessment Suicide 



The authors wish to thank the dedicated staff members of Asociacion Civil Proyectos en Salud (PROESA), Peru and Instituto Materno Perinatal, Peru for their expert technical assistance with this research.

Author contributions

Each of the authors has participated sufficiently in the preparation of this manuscript to warrant authorship.


This research was supported by awards from the National Institutes of Health (T32-MH-093310 and R01-HD-059835). The NIH had no further role in study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication.

Compliance with ethical standards

All participants provided written informed consent prior to interview. The institutional review boards of the INMP, Lima, Peru and the Harvard T. H. Chan School of Public Health, Office of Human Research Administration, Boston, MA, approved all procedures used in this study.

Conflicts of interest

The authors declare that they have no conflict of interest.

Research involving human participants

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2018

Authors and Affiliations

  1. 1.The Chester M. Pierce, MD Division of Global PsychiatryMassachusetts General HospitalBostonUSA
  2. 2.Harvard Medical SchoolBostonUSA
  3. 3.Institute for Juvenile ResearchUniversity of Illinois College of MedicineChicagoUSA
  4. 4.Universidad Peruana Cayetano HerediaLimaPeru
  5. 5.Universidad Peruana de Ciencias AplicadasLimaPeru
  6. 6.Harvard T.H. Chan School of Public HealthBostonUSA

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