Restricted fetal growth and adverse maternal psychosocial and socioeconomic conditions as risk factors for suicidal behaviour of offspring: a cohort study

Background Until now, sparse and contradictory results about an association between adverse neonatal, obstetric, and maternal conditions and heightened suicide risk in adolescents have been reported. The aims of this study were to investigate the relations between fetal growth, obstetric complications, and the mother's psychosocial and socioeconomic situation and the risk in early adulthood of suicide and attempted suicide in the offspring. Methods Obstetric, neonatal, and maternal risk factors for suicide and attempted suicide in 713 370 young adults, born in Sweden between 1973 and 1980, who were followed-up until Dec 31, 1999, were examined by data linkage between Swedish registers. Univariate and multivariate hazard ratios, derived from proportional-hazard models, were estimated. Findings Significantly raised risk of attempted suicide was reported for individuals of short birth length, adjusted for gestational age (hazard ratio 1.29, 95% Cl 1.18-1.41, p < 0.0001); born fourth or more in birth order (1.79, 1.62-1.97, p < 0.0001); born to mothers with a low educational level (1.36, 1.27-1.46, p < 0.0001) (attributable proportion 10.3%); and those who, at time of delivery, had mothers aged 19 years or younger (2.09, 1.89-2.32, p < 0.0001). Significant predictors of suicide were low birthweight, adjusted for gestational age (2.23, 1.43-3.46, p < 0.0001), and teenage motherhood (2.30, 1.64-3.22, p < 0.0001). Interpretation Multiparity and low maternal education predicted suicide attempt, whereas restricted fetal growth and teenage motherhood were associated with both suicide completion and attempt in offspring.