Researchers at Columbia University have\u00a0found that\u00a0accidental drug overdose, homicide, and suicide\u00a0are\u00a0the\u00a0leading\u00a0causes of death\u00a0among pregnant and postpartum\u00a0women.\u00a0<\/p>\n
The findings were published in the New England Journal of Medicine.\u00a0<\/p>\n
“Overdose and violence\u00a0are\u00a0not typically\u00a0on our radar\u00a0when it comes to thinking\u00a0about approaches to reducing maternal morbidity and mortality, but these events are\u00a0far more common among pregnant and postpartum women than we think,” says Hooman Azad, who led the study and is a maternal-fetal medicine fellow in the Department of Obstetrics and Gynecology at Columbia University\u00a0Vagelos\u00a0College of Physicians and Surgeons.\u00a0<\/p>\n
The researchers\u00a0used information on death certificates\u00a0to\u00a0identify\u00a0all pregnant and\u00a0postpartum\u00a0women (within\u00a042 days\u00a0of delivery)\u00a0who died\u00a0in the United States\u00a0between 2018 and 2023.\u00a0<\/p>\n
Their analysis revealed that accidental\u00a0overdose was the leading cause of death\u00a0among pregnant or postpartum women\u00a0(5.2 deaths per 100,000 births),\u00a0followed by\u00a0homicide and suicide\u00a0(combined for\u00a03.9 deaths per 100,000 births).\u00a0Accidental overdose and suicide\u00a0were\u00a0more\u00a0common\u00a0among\u00a0white women;\u00a0homicide was more frequent among Black women. Over three-quarters of violent deaths involved firearms.\u00a0<\/p>\n
Except for an increase during the COVID-19 pandemic, the overall maternal death rate remained steady over the six-year period.\u00a0<\/p>\n
Over half\u00a0of\u00a0deaths due to accidental overdose and\u00a0violence\u00a0occurred during pregnancy,\u00a0whereas\u00a0the next four most common\u00a0causes of death-cardiovascular disease, infection, hypertension, and hemorrhage-occurred more often in the\u00a0immediate\u00a0postpartum period.\u00a0<\/p>\n
As\u00a0interventions to\u00a0prevent\u00a0and\u00a0treat\u00a0medical complications\u00a0during pregnancy and postpartum\u00a0have\u00a0become more\u00a0widespread\u00a0over the past two decades,\u00a0multiple studies have shown that\u00a0accidental overdose and violence\u00a0have accounted for\u00a0increasing numbers of\u00a0maternal deaths.\u00a0But until recently,\u00a0a lack of standardized data-due to different methods for documenting pregnancy in death records-has\u00a0made it difficult to track these trends.\u00a0<\/p>\n
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The take-home message is that\u00a0we may not do as good a job in screening\u00a0for\u00a0drug use and intimate partner violence\u00a0among our\u00a0pregnant\u00a0patients as we do\u00a0for\u00a0medical complications. We have an opportunity to\u00a0refocus our efforts on preventing\u00a0drug\u00a0overdose and violence with\u00a0multidisciplinary care that includes\u00a0referrals to\u00a0mental health care\u00a0and social services\u00a0throughout pregnancy-which could save hundreds of lives.”\u00a0<\/p>\n
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Hooman Azad,\u00a0maternal-fetal medicine fellow, Department of Obstetrics and Gynecology, Columbia University\u00a0Vagelos\u00a0College of Physicians and Surgeons<\/p>\n
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Source:<\/p>\n
Columbia University Irving Medical Center<\/a><\/p>\n Journal reference:<\/p>\n