Maternal mortality by suicide in Morocco: prevalence and characteristics (study from 2003 to 2013)

Abstract

Introduction: the reduction of maternal deaths is highly valued by the global society. In Morocco, there isn't yet a suicide registry. This study was out to identify the characteristics of pregnancy-related deaths of Moroccan expectant mothers, determine the prevalence of perinatal suicide, and evaluate its risk factors.

Methods: this is a retrospective descriptive study on maternal suicides in the Moroccan population between the ages of 14 and 45. The suicides happened between the time of pregnancy and the first two years after delivery. The study covered a ten-year period and focused on the death registry of Casablanca's forensic pathology department (January 2003-December 2013). To describe the characteristics of pregnancy-related deaths with a known cause of death among Moroccan mothers, the circumstances of their deaths, the manners used for suicide, and the presence of potentially stressful events, we developed a structured survey. In cooperation with the medical examiners, two psychiatrists collected the data.

Results: a total of 44 deaths by suicide were reported. Prevalence of suicide was 16.05% compared with the general female population (N= 274) and 3.85% of total deaths by suicide (N= 1142) in both sexes. The mean age of Moroccan suicidal mothers was 26.26 ± is 7.09 (range: 16-44 years). Twenty five mothers were singles (or 56.82%) and ten were multiparous (22.73%). The educational attainment was primary school or less in 13.63% mothers (N=5), high school in 9.09% (N=4), and not specified in 77.27% (N= 34 cases). Furthermore, 63.64% (N= 28) were of rural origin. A history of substance abuse was reported in one suicidal mother (2.27%). Two mothers (4.54%) had history of mental illness and one suicide attempt (2.27%). The suicide happened at the first trimester of pregnancy in 31.82% (N=14). The most used method was drug overdose in 61.36% (N=27), and suicide had occurred in response to stressful life events in 31.82% (N=14).

Conclusion: although there is a dearth of high-quality information about suicide in Morocco, it is undeniably a serious and expanding public health issue.