Maternal Drug-related Death and Suicide are Leading Causes of Postpartum Death in California

Abstract

(Am J Obstet Gynecol. 2019;221:489.e1–489.e9) Efforts to reduce maternal mortality has become a priority worldwide and in the United States. In 2018, the Preventing Maternal Deaths Act was enacted to support state efforts to track and review maternal deaths. Also, targeted action plans and safety bundles for clinical care that focus on common causes of maternal mortality have been developed. Yet, there is limited evidence on the impact that drug-related deaths and suicide have on postpartum women. The aim of this study was to determine the incidence of drug-related deaths and suicide among women in California up to a year after giving birth and to examine their utilization of health care services between delivery and postpartum death.

Association between extremely preterm caesarean delivery and maternal depressive and anxious symptoms: a national population‐based cohort study

“…Depending on the measurement scale, some authors have reported up to one‐third of women presenting high levels of depression symptomatology 1 . A recent population‐based cohort study has shown suicide to be a major contributor to mortality in the postpartum period 2–4 . Preterm births have been documented as presenting a risk for post‐traumatic stress disorder (PTSD), acute stress disorder, depression and anxiety for parents (mothers in particular) compared with full‐term births 5–8 .…”

Maternal Mortality Among American Indian/Alaska Native Women: A Scoping Review

“…Palladino et al 26 reported that prenatal and postpartum suicide disproportionately affects AI/AN and white women, yet, others report little or no risk for AI/AN women. 20,21,[23][24][25]27 This result could be explained partially by the use of an ''Other'' race/ethnicity category; Palladino et al was the only study that reported AI/AN women as AI/AN versus ''Other. ''…”

“…21 Suicide rates for ''Other'' women (an unknown portion of which were AI/AN) ranged from 0% to 13.3%. 20,23,24,27,28,38 Substance use. We found no studies examining AI/AN pregnancy-associated maternal mortality from substance use.…”

“…Even less is under-stood about AI/AN pregnancy-associated deaths, with divergent studies reporting that suicide disproportionately affects AI/AN women 26 while others report the opposite. 20,21,[23][24][25]27 Mental illness contributes to U.S. maternal mortality and is a leading cause of death. 46 Although suicide can be a consequence of mental illness such as depression, 47 we found no studies exploring the relationship between depression and AI/AN maternal mortality.…”

Pregnancy-Associated Deaths from Homicide, Suicide, and Drug Overdose: Review of Research and the Intersection with Intimate Partner Violence

“…Women who consider, attempt, and/or carry out suicide often have recent interactions with health care providers before their deaths. 43 In 2018, ACOG published updated clinical guidance for women's health providers to screen patients at least once during the perinatal period for depression and anxiety using standardized, validated tools. During postpartum visits, more extensive emotional health assessments and referrals may be indicated.…”