Prevalence and Risk Factors of Suicidal Ideation among Pregnant Adolescents in Low- and Middle-Income Countries: A Scoping Epidemiological Review

Abstract

Background: Adolescent pregnancy is a major public health concern in low- and middle-income countries (LMICs), with poor maternal and mental health outcomes driven by socioeconomic vulnerability, gender inequality, and limited access to care. Suicidal ideation among pregnant adolescents is underexplored and linked to stigma, social isolation, early marriage, and intimate partner violence, but evidence on its prevalence and determinants remains fragmented Objectives: • To synthesize evidence on the prevalence and risk factors of suicidal ideation among pregnant adolescents in LMICs • To identify psychosocial, demographic, and health-related correlates • To analyze regional variations; and to highlight gaps to inform future research and policy. Methods: This study is a scoping review conducted following the Arksey and O’Malley framework and further refined by Levac et al. and the Joanna Briggs Institute (JBI) guidelines. Reporting adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). A systematic search was performed across PubMed, Scopus, and Google Scholar, along with grey literature from the World Health Organization (WHO), United Nations Children’s Fund (UNICEF), and United Nations Population Fund (UNFPA), covering publications from 2000 to 2024. Results: The 40 studies covered 23 LMICs in Sub-Saharan Africa, South Asia, and Latin America. Suicidal ideation ranged from 5.2% to 46.5%, with attempts up to 18%. Key correlates included depression, intimate partner violence, abuse, stigma, poverty, unplanned pregnancy, prior trauma, low education, and poor social support. Most studies were cross-sectional with methodological heterogeneity, limiting causal inference Conclusion: Suicidal ideation among pregnant adolescents in low- and middle-income countries is a significant yet underrecognized burden, with prevalence ranging from 5.2% to 46.5% and suicide attempts up to 18%. Key risk factors include depression, intimate partner violence, unplanned pregnancy, and poor social support. Despite methodological variability, findings consistently indicate multifactorial vulnerability, underscoring the need for standardized screening and integration of mental health care into antenatal services.