Hospitalisation for non‐lethal self‐harm and premature mortality in the 3 years following adolescent pregnancy: Population‐based nationwide cohort study

Author:

Goueslard Karine1,Jollant Fabrice2345,Cottenet Jonathan1,Bechraoui‐Quantin Sonia16,Rozenberg Patrick7,Simon Emmanuel6ORCID,Quantin Catherine18ORCID

Affiliation:

1. Biostatistics and Bioinformatics (DIM), University Hospital Bourgogne Franche‐Comté University Dijon France

2. Department of Psychiatry Paris‐Saclay University and Academic Hospital (CHU) Bicêtre Le Kremlin‐Bicêtre France

3. Department of Psychiatry Nîmes Academic Hospital (CHU) Nîmes France

4. Department of Psychiatry McGill University Montreal Quebec Canada

5. MOODS Research Team, Centre de recherche en Epidémiologie et santé des populations (CESP), Institut national de la santé et de la recherche médicale (Inserm) Le Kremlin‐Bicêtre France

6. Gynecology, Obstetrics and Fetal Medicine University Hospital Dijon France

7. Department of Obstetrics and Gynecology, Hôpital Intercommunal de Poissy Université Versailles Saint‐Quentin Poissy France

8. Inserm, High‐Dimensional Biostatistics for Drug Safety and Genomics, CESP Université Paris‐Saclay, Université Versailles Saint‐Quentin, Université Paris‐Sud Villejuif France

Abstract

AbstractObjectiveTo evaluate the risk of non‐lethal self‐harm and mortality related to adolescent pregnancy.DesignNationwide population‐based retrospective cohort.SettingData were extracted from the French national health data system.PopulationWe included all adolescents aged 12–18 years with an International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD‐10) code for pregnancy in 2013–2014.MethodsPregnant adolescents were compared with age‐matched non‐pregnant adolescents and with first‐time pregnant women aged 19–25 years.Main outcome measuresAny hospitalisation for non‐lethal self‐harm and mortality during a 3‐year follow‐up period. Adjustment variables were age, a history of hospitalisation for physical diseases, psychiatric disorders, self‐harm and reimbursed psychotropic drugs. Cox proportional hazards regression models were used.ResultsIn 2013–2014, 35 449 adolescent pregnancies were recorded in France. After adjustment, pregnant adolescents had an increased risk of subsequent hospitalisation for non‐lethal self‐harm in comparison with both non‐pregnant adolescents (n = 70 898) (1.3% vs 0.2%, HR 3.06, 95% CI 2.57–3.66) and pregnant young women (n = 233 406) (0.5%, HR 2.41, 95% CI 2.14–2.71). Rates of hospitalisation for non‐lethal self‐harm were lower during pregnancy and higher between 12 and 8 months pre‐delivery, 3–7 months postpartum and in the month following abortion. Mortality was significantly higher in pregnant adolescents (0.7‰) versus pregnant young women (0.4‰, HR 1.74, 95% CI 1.12–2.72), but not versus non‐pregnant adolescents (0.4‰, HR 1.61, 95% CI 0.92–2.83).ConclusionsAdolescent pregnancy is associated with an increased risk of hospitalisation for non‐lethal self‐harm and premature death. Careful psychological evaluation and support should be systematically implemented for adolescents who are pregnant.

Publisher

Wiley

Subject

Obstetrics and Gynecology

Cited by 4 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Self-harm and suicide death in the three years following hospitalization for intentional self-harm in adolescents and young adults: A nationwide study;Psychiatry Research;2024-04

2. Teen Pregnancy and Risk of Premature Mortality;JAMA Network Open;2024-03-14

3. Author reply;BJOG: An International Journal of Obstetrics & Gynaecology;2023-09-15

4. Mental health sequelae of adolescent pregnancy;BJOG: An International Journal of Obstetrics & Gynaecology;2023-06-27

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