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Fernandez Turienzo, C 
ORCID: 0000-0002-7393-6593, Erpolat, YD, De Backer, K, Burton, S ORCID: 0000-0003-3823-3275, Rayment-Jones, H, Wilson, CA, Sandall, J ORCID: 0000-0003-2000-743X and Easter, A
(2026)
Interventions to prevent suicide and suicidal thoughts or behaviours in the perinatal period: a global mixed-methods systematic review.
eClinicalMedicine, 101.
ISSN 2589-5370
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Abstract
Background
Suicide is a leading cause of maternal death during the perinatal period. While routine enquiry and identification is widely recommended, evidence on comprehensive interventions remains limited. This review evaluated global evidence on the effectiveness of interventions for perinatal suicide, associated thoughts and behaviours, and key implementation features.
Methods
We conducted a mixed-methods systematic review using the Joanna Briggs Institute methodology. We searched eight databases and other sources from inception to December 3, 2025, for global evidence across all income settings without language restrictions. We included studies evaluating interventions, programmes or strategies reporting on our primary outcome: perinatal suicide or suicidal thoughts or behaviours (including ideation, self-harm, attempts) during pregnancy or one year after birth. Data were extracted and appraised for methodological quality. Meta-analysis was not possible due to clinical and methodological heterogeneity; data were synthesised using a convergent integrated approach. PROSPERO: CRD42025625903.
Findings
We screened 27,045 records; 19 records representing nine studies were included: three randomised controlled trials, one secondary analysis of a randomised controlled trial, one non-randomised controlled trial, one quasi-experimental study, one cross-sectional descriptive study, one economic modelling, and one qualitative study. Studies were conducted between 2011 and 2025 in North America, Europe and Asia and included 3613 participants from at risk or disadvantaged populations across eight studies, plus a simulated cohort of 1000. We found trials of indirect clinical interventions targeting parenting or attachment did not reduce suicidality, whereas task-shared behavioural activation psychotherapy targeting depressive drivers, was associated with an 80% reduction in odds of suicidal ideation at three months in a secondary trial analysis. System or community-level strategies in three trials and the modelling were associated with reduced suicide or suicidal ideation by integrating routine screening within multidisciplinary pathways that ensured immediate linkage to care. Informal or crisis support mechanisms facilitated immediate access and worked as protective buffers against self-harm in two feasibility and qualitative studies; faith practices helped counter barriers to formal care while helplines remained limited by them.
Interpretation
Our results suggest that suicide prevention could be improved by embedding routine identification within coordinated health and community safety nets ensuring immediate linkage to care. Expanding evidence-based psychological care and task-sharing targeting depressive drivers of suicidality may help at-risk women receive timely support. Future research explicitly designed and powered for perinatal suicide prevention is needed.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | 3202 Clinical sciences; 4203 Health services and systems; 4206 Public health |
| Subjects: | B Philosophy. Psychology. Religion > BF Psychology H Social Sciences > HQ The family. Marriage. Woman R Medicine > RG Gynecology and obstetrics |
| Divisions: | Psychology (from Sep 2019) |
| Publisher: | Elsevier BV |
| Date of acceptance: | 23 October 2026 |
| Date of first compliant Open Access: | 9 November 2026 |
| Date Deposited: | 09 Nov 2026 14:46 |
| Last Modified: | 09 Nov 2026 14:46 |
| DOI or ID number: | 10.1016/j.eclinm.2026.104318 |
| URI: | https://researchonline.ljmu.ac.uk/id/eprint/29852 |
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