Suicidal ideation and associated factors among pregnant women attending antenatal care at public hospitals of Harari regional state, eastern Ethiopia: A cross-sectional study

Background
Suicide is a global issue. It is the third responsible for death among the reproductive age group. Pregnancy is a complicated event and crucial in the life of a woman with considerable physiological, hormonal changes, social, and mental changes. However, third-world countries like Ethiopia have not been investigated well. Therefore, the study planned to assess the magnitude and factors associated with suicidal ideation. Furthermore, it will identify the role of hyperemesis gravidarum on suicidal ideation.

Method
A Cross-sectional study was employed for 543 pregnant participants attending antenatal care at Hiwot Fana Specialized University Hospital and Jugal General Hospital, Harari regional state, eastern Ethiopia from June 1 to August 1, 2022. The recruited participants were selected by systematic random sampling method. Suicide was assessed using Composite International Diagnostic by interview methods data collection. Epi data and STATA version 14.1 were used for data entry and analysis respectively. Candidate variables were entered into a multivariate logistic regression then those variables that have p-value < 0.05 were considered as significantly associated.

Results
The magnitude of suicidal ideation in this study was found to be 11.15% at (95% CI: 8.75–14.11). Regarding the associated factor, unwanted pregnancy (AOR = 3.39: at 95% CI = 1.58–7.27), Hyperemesis gravidarum (AOR = 3.65: at 95% CI = 1.81–7.34), having depressive symptoms (AOR = 2.79: at 95% CI = 1.49–5.23), having anxiety symptoms (AOR = 3.37; at 95% CI = 1.69–6.68), experiencing intimate partner violence (AOR = 2.88: at 95% CI = 1.11–7.46), and having stress (AOR = 3.46; at 95% CI = 1.75–6.86) were significantly associated variable with suicidal ideation among pregnant women.

Conclusion and recommendation
This study revealed that suicidal ideation is common among pregnant women. Regarding the associated factors unwanted pregnancy, hyperemesis gravidarum, having depressive and anxiety symptoms, experiencing intimate partner violence, and stress were significantly associated with suicidal ideation. Thus, giving awareness and early screening and interferences for antenatal suicide should be warranted.