Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Advertisement

Scientific Reports
  • View all journals
  • Search
  • My Account Login
  • Content Explore content
  • About the journal
  • Publish with us
  • Sign up for alerts
  • RSS feed
  1. nature
  2. scientific reports
  3. articles
  4. article
The protective effect of pregnancy on risk for suicide attempt in a Swedish national cohort
Download PDF
Download PDF
  • Article
  • Open access
  • Published: 22 April 2026

The protective effect of pregnancy on risk for suicide attempt in a Swedish national cohort

  • Mallory Stephenson1 na1,
  • Séverine Lannoy1 na1,
  • Henrik Ohlsson2,
  • Jan Sundquist2,3,
  • Casey Crump4,
  • Kristina Sundquist2,3 &
  • …
  • Alexis C. Edwards1 

Scientific Reports (2026) Cite this article

  • 553 Accesses

  • Metrics details

We are providing an unedited version of this manuscript to give early access to its findings. Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply.

Subjects

  • Diseases
  • Health care
  • Medical research
  • Risk factors

Abstract

We used national Swedish registry data to investigate the nature of the association between pregnancy and decreased risk for suicide attempt (SA). Analyses included pregnant individuals aged 18–35, biological fathers, and matched controls born 1975–1995. Data were available for between 366,125 and 2,129,244 females (depending on the model) and 359,622 males. We evaluated risk for SA as a function of pregnancy status using three methods designed to strengthen causal inference: a matched cohort design, co-relative analyses, and within-individual analyses. In within-individual analyses, we also examined potential moderators of the pregnancy-SA association, and we conducted separate analyses in the unborn children’s biological fathers. Across all analyses, pregnancy was associated with a lower risk of SA (ORs = 0.15–0.30). Moderation analyses indicated that the potentially protective effect of pregnancy was stronger in unmarried individuals, those with prior registration for externalizing or internalizing disorders, and younger individuals. Decreased SA risk was also observed during the postpartum period (ORs = 0.16–0.31) and in biological fathers (ORs = 0.67–0.82). These findings suggest that risk for non-fatal SA is substantially lower during pregnancy in expectant mothers and fathers, and the association between pregnancy and reduced SA risk may be causal.

Similar content being viewed by others

Sex difference in parental risk of suicide attempt during and after pregnancy in Sweden

Article Open access 25 September 2025

Associations of parental and perinatal factors with subsequent risk of stress-related disorders: a nationwide cohort study with sibling comparison

Article Open access 01 January 2022

Maternal sexuality in high- and low-risk pregnancies: a cross-sectional comparison

Article Open access 23 February 2026

Data availability

The Swedish registry data are not publicly available. However, we are willing to share the code related to the present project. Please contact Dr. Henrik Ohlsson (henrik.ohlsson@med.lu.se) for any questions related to the analyses.

References

  1. Servin-Barthet, C. et al. The transition to motherhood: Linking hormones, brain and behaviour. Nat. Rev. Neurosci. 24(10), 605–619. https://doi.org/10.1038/s41583-023-00733-6 (2023).

    Google Scholar 

  2. Brandon, A. R., Pitts, S., Denton, W. H., Stringer, C. A. & Evans, H. M. A history of the theory of prenatal attachment. J Prenat Perinat Psychol Health APPPAH 23(4), 201–222 (2009).

    Google Scholar 

  3. Gioia, M. C. et al. The relationship between maternal-fetus attachment and perceived parental bonds in pregnant women: Considering a possible mediating role of psychological distress. Front Psychol. 13, 1095030. https://doi.org/10.3389/fpsyg.2022.1095030 (2022).

    Google Scholar 

  4. Rosa, KMda et al. Maternal-fetal attachment and perceived parental bonds of pregnant women. Early Hum. Dev. 154, 105310. https://doi.org/10.1016/j.earlhumdev.2021.105310 (2021).

    Google Scholar 

  5. Edwards, A. C. et al. Protective effects of pregnancy on alcohol use disorder risk. Am. J. Psychiatry. 176(2), 138. https://doi.org/10.1176/appi.ajp.2018.18050632 (2018).

    Google Scholar 

  6. Pinto, E., Barros, H. & dos Santos Silva, I. Dietary intake and nutritional adequacy prior to conception and during pregnancy: A follow-up study in the north of Portugal. Public Health Nutr. 12(7), 922–931. https://doi.org/10.1017/S1368980008003595 (2009).

    Google Scholar 

  7. Harrison, P. A. & Sidebottom, A. C. Alcohol and drug use before and during pregnancy: An examination of use patterns and predictors of cessation. Matern. Child Health J. 13(3), 386–394. https://doi.org/10.1007/s10995-008-0355-z (2009).

    Google Scholar 

  8. Kendler, K. S., Ohlsson, H., Svikis, D. S., Sundquist, K. & Sundquist, J. The protective effect of pregnancy on risk for drug abuse: A population, co-relative, co-spouse, and within-individual analysis. Am. J. Psychiatry. 174(10), 954. https://doi.org/10.1176/appi.ajp.2017.16091006 (2017).

    Google Scholar 

  9. Román-Gálvez, M. R. et al. Caffeine intake throughout pregnancy, and factors associated with non-compliance with recommendations: A cohort study. Nutrients 14(24), 5384. https://doi.org/10.3390/nu14245384 (2022).

    Google Scholar 

  10. Appleby, L. Suicide during pregnancy and in the first postnatal year. BMJ 302(6769), 137–140. https://doi.org/10.1136/bmj.302.6769.137 (1991).

    Google Scholar 

  11. Marzuk, P. M. et al. Lower risk of suicide during pregnancy. Am J Psychiatry. 154(1), 122–123. https://doi.org/10.1176/ajp.154.1.122 (1997).

    Google Scholar 

  12. Lindahl, V., Pearson, J. L. & Colpe, L. Prevalence of suicidality during pregnancy and the postpartum. Arch. Womens Ment. Health 8(2), 77–87. https://doi.org/10.1007/s00737-005-0080-1 (2005).

    Google Scholar 

  13. Gissler, M., Berg, C., Bouvier-Colle, M. H. & Buekens, P. Injury deaths, suicides and homicides associated with pregnancy, Finland 1987–2000. Eur. J. Public Health 15(5), 459–463. https://doi.org/10.1093/eurpub/cki042 (2005).

    Google Scholar 

  14. Khalifeh, H., Hunt, I. M., Appleby, L. & Howard, L. M. Suicide in perinatal and non-perinatal women in contact with psychiatric services: 15 year findings from a UK national inquiry. Lancet Psychiatry 3(3), 233–242. https://doi.org/10.1016/S2215-0366(16)00003-1 (2016).

    Google Scholar 

  15. Ayre, K., Gordon, H. G., Dutta, R., Hodsoll, J. & Howard, L. M. The prevalence and correlates of self-harm in the perinatal period: A systematic review. J. Clin. Psychiatry 81(1), 15343. https://doi.org/10.4088/JCP.19r12773 (2019).

    Google Scholar 

  16. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web-based injury statistics query and reporting system (WISQARS). Published online 2022. Accessed January 8, 2025. www.wisqars.cdc.gov

  17. Kendell, R. E. Suicide in pregnancy and the puerperium. BMJ 302(6769), 126–127 (1991).

    Google Scholar 

  18. Linehan, M. M., Goodstein, J. L., Nielsen, S. L. & Chiles, J. A. Reasons for staying alive when you are thinking of killing yourself: The reasons for living inventory. J. Consult. Clin. Psychol. 51(2), 276–286 (1983).

    Google Scholar 

  19. Klonsky, E. D. & May, A. M. The three-step theory (3ST): A new theory of suicide rooted in the “ideation-to-action” framework. Int. J. Cogn. Ther. 8(2), 114–129. https://doi.org/10.1521/ijct.2015.8.2.114 (2015).

    Google Scholar 

  20. Joiner, T. Why people die by suicide (Harvard University Press, Cambridge, 2005).

    Google Scholar 

  21. Van Orden, K. A. et al. The interpersonal theory of suicide. Psychol. Rev. 117(2), 575–600. https://doi.org/10.1037/a0018697 (2010).

    Google Scholar 

  22. O’Connor, R. C. Towards an integrated motivational-volitional model of suicidal behaviour. In International handbook of suicide prevention: Research, policy and practice 181–198 (2011).

    Google Scholar 

  23. Xie, F. et al. Association between physical activity and infertility: A comprehensive systematic review and meta-analysis. J. Transl. Med. 20, 237. https://doi.org/10.1186/s12967-022-03426-3 (2022).

    Google Scholar 

  24. Grasdalsmoen, M., Eriksen, H. R., Lønning, K. J. & Sivertsen, B. Physical exercise, mental health problems, and suicide attempts in university students. BMC Psychiatry 20, 175. https://doi.org/10.1186/s12888-020-02583-3 (2020).

    Google Scholar 

  25. Arnone, D. et al. Risk of suicidal behavior in patients with major depression and bipolar disorder—A systematic review and meta-analysis of registry-based studies. Neurosci. Biobehav. Rev. 159, 105594. https://doi.org/10.1016/j.neubiorev.2024.105594 (2024).

    Google Scholar 

  26. Liao, T. et al. Preconception depression reduces fertility: A couple-based prospective preconception cohort. Hum. Reprod. Open 2024(3), hoae032. https://doi.org/10.1093/hropen/hoae032 (2024).

    Google Scholar 

  27. White, M. A., Wilson, M. E., Elander, G. & Persson, B. The Swedish family: Transition to parenthood. Scand. J. Caring Sci. 13(3), 171–176 (1999).

    Google Scholar 

  28. Wilson, M. E. et al. Family dynamics, parental-fetal attachment and infant temperament. J. Adv. Nurs. 31(1), 204–210. https://doi.org/10.1046/j.1365-2648.2000.01245.x (2000).

    Google Scholar 

  29. Lorensen, M., Wilson, M. E. & White, M. A. Norwegian families: Transition to parenthood. Health Care Women Int. 25(4), 334–348. https://doi.org/10.1080/07399330490278394 (2004).

    Google Scholar 

  30. Cnattingius, S. et al. The Swedish medical birth register during five decades: Documentation of the content and quality of the register. Eur. J. Epidemiol. 38(1), 109–120. https://doi.org/10.1007/s10654-022-00947-5 (2023).

    Google Scholar 

  31. Ekbom, A. The Swedish multi-generation register. In Methods in biobanking (ed. Dillner, J.) 215–220 (Humana Press, 2011). https://doi.org/10.1007/978-1-59745-423-0_10.

    Google Scholar 

  32. Ludvigsson, J. F. et al. Registers of the Swedish total population and their use in medical research. Eur. J. Epidemiol. 31(2), 125–136. https://doi.org/10.1007/s10654-016-0117-y (2016).

    Google Scholar 

  33. Edwards, A. C. et al. On the genetic and environmental relationship between suicide attempt and death by suicide. Am. J. Psychiatry. https://doi.org/10.1176/appi.ajp.2020.20121705 (2021).

    Google Scholar 

  34. Björkenstam, C., Kosidou, K., Björkenstam, E. Childhood adversity and risk of suicide: cohort study of 548 721 adolescents and young adults in Sweden. Published online April 19. https://doi.org/10.1136/bmj.j1334 (2017).

  35. Chen, Q. et al. Predicting suicide attempt or suicide death following a visit to psychiatric specialty care: A machine learning study using Swedish national registry data. PLoS Med. 17(11), e1003416. https://doi.org/10.1371/journal.pmed.1003416 (2020).

    Google Scholar 

  36. Bittár, N. H., Falkstedt, D. & Wallin, A. S. How intelligence and emotional control are related to suicidal behavior across the life course—A register-based study with 38-year follow-up. Psychol. Med. 50(13), 2265–2271. https://doi.org/10.1017/S0033291719002423 (2020).

    Google Scholar 

  37. Kendler, K. S., Ohlsson, H., Sundquist, J. & Sundquist, K. Family genetic risk scores and the genetic architecture of major affective and psychotic disorders in a Swedish national sample. JAMA Psychiat. 78(7), 7. https://doi.org/10.1001/jamapsychiatry.2021.0336 (2021).

    Google Scholar 

  38. Kendler, K. S. et al. Genetic liability to suicide attempt, suicide death, and psychiatric and substance use disorders on the risk for suicide attempt and suicide death: A Swedish national study. Psychol. Med. 53(4), 1639–1648. https://doi.org/10.1017/S0033291721003354 (2023).

    Google Scholar 

  39. Stuart, E. A. Matching methods for causal inference: A review and a look forward. Stat. Sci. 25(1), 1–21. https://doi.org/10.1214/09-STS313 (2010).

    Google Scholar 

  40. D’Onofrio, B. M., Lahey, B. B., Turkheimer, E. & Lichtenstein, P. Critical need for family-based, quasi-experimental designs in integrating genetic and social science research. Am. J. Public Health. 103(Suppl 1), Suppl 1. https://doi.org/10.2105/AJPH.2013.301252 (2013).

    Google Scholar 

  41. Maclure, M. & Mittleman, M. A. Should we use a case-crossover design?. Annu. Rev. Public Health 21, 193–221. https://doi.org/10.1146/annurev.publhealth.21.1.193 (2000).

    Google Scholar 

  42. Lahey, B. B. & D’Onofrio, B. M. All in the family: Comparing siblings to test causal hypotheses regarding environmental influences on behavior. Curr. Dir. Psychol. Sci. 19(5), 5. https://doi.org/10.1177/0963721410383977 (2010).

    Google Scholar 

  43. Kendler, K. S., Ohlsson, H., Sundquist, K. & Sundquist, J. The causal nature of the association between neighborhood deprivation and drug abuse: A prospective national Swedish co-relative control study. Psychol. Med. 44(12), 2537. https://doi.org/10.1017/S0033291713003048 (2014).

    Google Scholar 

  44. Sharma, R., Biedenharn, K. R., Fedor, J. M. & Agarwal, A. Lifestyle factors and reproductive health: Taking control of your fertility. Reprod. Biol. Endocrinol. 11, 66. https://doi.org/10.1186/1477-7827-11-66 (2013).

    Google Scholar 

  45. Kendler, K. S. & Gardner, C. O. Interpretation of interactions: Guide for the perplexed. Br. J. Psychiatry 197(3), 170–171. https://doi.org/10.1192/bjp.bp.110.081331 (2010).

    Google Scholar 

  46. Franklin, J. C. et al. Risk factors for suicidal thoughts and behaviors: A meta-analysis of 50 years of research. Psychol. Bull. 143(2), 187–232. https://doi.org/10.1037/bul0000084 (2017).

    Google Scholar 

  47. Gili, M. et al. Mental disorders as risk factors for suicidal behavior in young people: A meta-analysis and systematic review of longitudinal studies. J. Affect. Disord. 245, 152–162. https://doi.org/10.1016/j.jad.2018.10.115 (2019).

    Google Scholar 

  48. Stephenson, M., Prom-Wormley, E., Lannoy, S. & Edwards, A. C. The temporal relationship between marriage and risk for suicidal ideation. J. Affect. Disord. 343, 129–135. https://doi.org/10.1016/j.jad.2023.10.007 (2023).

    Google Scholar 

  49. Beghi, M. & Rosenbaum, J. F. Risk factors for fatal and nonfatal repetition of suicide attempt: A critical appraisal. Curr. Opin. Psychiatry 23(4), 349–355. https://doi.org/10.1097/YCO.0b013e32833ad783 (2010).

    Google Scholar 

  50. Lannoy, S. et al. Examining common and distinct contributions to the etiology of suicide attempt and reattempt. J. Psychopathol. Clin. Sci. 132(2), 165–172. https://doi.org/10.1037/abn0000802 (2023).

    Google Scholar 

  51. Nelson, H. D. et al. Associations of unintended pregnancy with maternal and infant health outcomes: A systematic review and meta-analysis. JAMA 328(17), 1714–1729. https://doi.org/10.1001/jama.2022.19097 (2022).

    Google Scholar 

  52. Bearak, J. et al. Unintended pregnancy and abortion by income, region, and the legal status of abortion: Estimates from a comprehensive model for 1990–2019. Lancet Glob. Health. 8(9), e1152–e1161. https://doi.org/10.1016/S2214-109X(20)30315-6 (2020).

    Google Scholar 

  53. Muskens, L. et al. The association of unplanned pregnancy with perinatal depression: A longitudinal cohort study. Arch. Womens Ment. Health. 25(3), 611. https://doi.org/10.1007/s00737-022-01225-9 (2022).

    Google Scholar 

  54. Hellerstedt, W. L. et al. Differences in preconceptional and prenatal behaviors in women with intended and unintended pregnancies. Am. J. Public Health. 88(4), 663–666. https://doi.org/10.2105/ajph.88.4.663 (1998).

    Google Scholar 

  55. Durkheim, E. Suicide: A study in sociology (Snowball Publishing, California, 2012).

    Google Scholar 

Download references

Funding

This study was supported by the National Institutes of Health (R01MH129356 to Alexis C. Edwards and K99AA030611 to Severine Lannoy) and the Swedish Research Council (2022–00812 to Kristina Sundquist).

Author information

Author notes
  1. Mallory Stephenson and Séverine Lannoy have co-first authors.

Authors and Affiliations

  1. Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA

    Mallory Stephenson, Séverine Lannoy & Alexis C. Edwards

  2. Center for Primary Health Care Research, Lund University, Malmö, Sweden

    Henrik Ohlsson, Jan Sundquist & Kristina Sundquist

  3. University Clinic Primary Care, Skåne University Hospital, Lund, Region Skåne, Sweden

    Jan Sundquist & Kristina Sundquist

  4. Departments of Family and Community Medicine and of Epidemiology, The University of Texas Health Science Center, Houston, TX, USA

    Casey Crump

Authors
  1. Mallory Stephenson
    View author publications

    Search author on:PubMed Google Scholar

  2. Séverine Lannoy
    View author publications

    Search author on:PubMed Google Scholar

  3. Henrik Ohlsson
    View author publications

    Search author on:PubMed Google Scholar

  4. Jan Sundquist
    View author publications

    Search author on:PubMed Google Scholar

  5. Casey Crump
    View author publications

    Search author on:PubMed Google Scholar

  6. Kristina Sundquist
    View author publications

    Search author on:PubMed Google Scholar

  7. Alexis C. Edwards
    View author publications

    Search author on:PubMed Google Scholar

Contributions

MS and SL contributed equally: They wrote the main manuscript text and prepared figures. HO, MS, SL, and AE designed the study aims and analytic approaches. HO conducted the analyses, while JS and KS ensured data access. All authors participated in the results interpretation and in editing and writing of the manuscript.

Corresponding author

Correspondence to Séverine Lannoy.

Ethics declarations

Competing Interests

The authors declare no competing interests.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Supplementary Information. (download DOCX )

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Stephenson, M., Lannoy, S., Ohlsson, H. et al. The protective effect of pregnancy on risk for suicide attempt in a Swedish national cohort. Sci Rep (2026). https://doi.org/10.1038/s41598-026-49192-w

Download citation

  • Received: 01 October 2025

  • Accepted: 13 April 2026

  • Published: 22 April 2026

  • DOI: https://doi.org/10.1038/s41598-026-49192-w

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

Keywords

  • Pregnancy
  • Suicide attempt
  • Mother
  • Father
Download PDF

Advertisement

Explore content

  • Research articles
  • News & Comment
  • Collections
  • Subjects
  • Follow us on Facebook
  • Follow us on X
  • Sign up for alerts
  • RSS feed

About the journal

  • About Scientific Reports
  • Contact
  • Journal policies
  • Guide to referees
  • Calls for Papers
  • Editor's Choice
  • Journal highlights
  • Open Access Fees and Funding

Publish with us

  • For authors
  • Language editing services
  • Open access funding
  • Submit manuscript

Search

Advanced search

Quick links

  • Explore articles by subject
  • Find a job
  • Guide to authors
  • Editorial policies

Scientific Reports (Sci Rep)

ISSN 2045-2322 (online)

nature.com footer links

About Nature Portfolio

  • About us
  • Press releases
  • Press office
  • Contact us

Discover content

  • Journals A-Z
  • Articles by subject
  • protocols.io
  • Nature Index

Publishing policies

  • Nature portfolio policies
  • Open access

Author & Researcher services

  • Reprints & permissions
  • Research data
  • Language editing
  • Scientific editing
  • Nature Masterclasses
  • Research Solutions

Libraries & institutions

  • Librarian service & tools
  • Librarian portal
  • Open research
  • Recommend to library

Advertising & partnerships

  • Advertising
  • Partnerships & Services
  • Media kits
  • Branded content

Professional development

  • Nature Awards
  • Nature Careers
  • Nature Conferences

Regional websites

  • Nature Africa
  • Nature China
  • Nature India
  • Nature Japan
  • Nature Middle East
  • Privacy Policy
  • Use of cookies
  • Legal notice
  • Accessibility statement
  • Terms & Conditions
  • Your US state privacy rights
Springer Nature

© 2026 Springer Nature Limited

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing