The association between the transition to parenthood and risk for nonfatal suicide attempt in a Swedish population-based sample

BACKGROUND: Parenthood is consistently identified as a protective factor for suicidal behavior. However, it remains unclear whether this relationship varies as a function of sex, age, time since birth, number of children, and other risk/protective factors. METHODS: We used Cox proportional hazards models to describe the relationship between the birth of up to four children and suicide attempt (SA) risk in Swedish individuals born between 1960 and 1980. Models were stratified by sex and controlled for a range of covariates. We tested whether the relationship between parenthood and SA risk varies based on age at first birth and explored whether SA risk differed based on education, genetic liability, cohabitation with one's co-parent, and geographic proximity to one's mother (the child's grandmother). RESULTS: The first year following childbirth was associated with reduced SA risk in mothers (hazard ratios [HRs] = 0.34-0.64) and fathers (HRs = 0.60-0.86). However, later time periods following the birth of one's third and fourth children were associated with elevated risk (HRs = 1.02-1.26). Moreover, age at first birth moderated the association between parenthood and SA: individuals who became parents at age 15 exhibited increased risk for SA (HRs = 2.81-5.30), while individuals with an older age at first birth (30+ years) experienced a reduction in risk (HRs = 0.31-0.92). The effect of parenthood also varied based on cohabitation and proximity to one's mother. CONCLUSIONS: These findings underscore the complexity of the relationship between parenthood and SA, indicating that there are some subgroups for whom the transition to parenthood is not protective. Clinical outreach may be warranted as a preventative measure.