Pregnancy-Associated Deaths in Virginia Due to Homicides, Suicides, and Accidental Overdoses Compared With Natural Causes

Bronson, Jennifer; Reviere, Rebecca

doi:10.1177/1077801216663658

Cited by 17 publications

(21 citation statements)

References 35 publications

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“…Homicide rates for ''Other'' women ranged from 0% to 3.8%. [20][21][22][23][26][27][28] Although this rate appears consistently low, homicide remains a leading cause of pregnancy-associated injury deaths in the United States. 22,26,35 Disparate numbers of missing and murdered Indigenous women 37 suggest that homicide may be responsible for more pregnancy-associated AI/AN deaths than has been recognized to date.…”

Section: Resultsmentioning

confidence: 99%

“…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. ''…”

Section: Resultsmentioning

confidence: 99%

“…One study that included AI/AN maternal deaths as ''Other'' still reported too few suicides to discuss. 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.…”

Section: Resultsmentioning

confidence: 99%

“…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.…”

Section: Discussionmentioning

confidence: 99%

“…64 In addition, with low numbers, cases are discussed together to protect confidentiality and privacy. 21,26,38 AI/AN maternal deaths are classified in an ''Other'' racial/ethnic category where the AI/AN proportion could be anywhere from 0% to 100%, complicating interpretation of AI/AN maternal mortality. This lack of data prevents clear understanding and hindered us from determining leading cause(s) of AI/AN pregnancyassociated maternal mortality.…”

Section: Discussionmentioning

confidence: 99%

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

Heck

Jones

Bohn

et al. 2021

Journal of Women's Health

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Background: Maternal mortality decreased globally by about 38% between 2000 and 2017, yet, it continues to climb in the United States. Gaping disparities exist in U.S. maternal mortality between white (referent group) and minority women. Despite important and appropriate attention to disparities for black women, almost no attention has been given to American Indian/Alaska Native (AI/AN) women. The purpose of this scoping review is to synthesize available literature concerning AI/AN maternal mortality. Methods: Databases were searched using the terms maternal mortality and pregnancy-related death, each paired with American Indian, Native American, Alaska Native, Inuit, and Indigenous. Criteria (e.g., hemorrhage) were paired with initial search terms. Next, pregnancy-associated death was paired with American Indian, Native American, Alaska Native, Inuit, and Indigenous. Criteria in this category were homicide, suicide, and substance use. Results: The three leading causes of AI/AN pregnancy-related maternal mortality are hemorrhage, cardiomyopathies, and hypertensive disorders of pregnancy. AI/AN maternal mortality data for homicide and suicide consistently include small samples and often categorize AI/AN maternal deaths in an ''Other'' race/ethnicity, which precludes targeted AI/AN data analysis. No studies that reported AI/AN maternal mortality as a result of substance use were found. Health care characteristics such as quality, access, and location also may influence maternal outcomes and maternal mortality. Conclusions: Despite AI/AN maternal mortality being disproportionately high compared to other racial/ethnic groups, relatively little is known about root causes.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

Heck

Jones

Bohn

et al. 2021

Journal of Women's Health

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Intimate Partner Violence, Firearm Violence, and Human Rights in the United States

Bronson¹

2020

Why We Are Losing the War on Gun Violence in the United States

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Implementation of a Prenatal Naloxone Distribution Program to Decrease Maternal Mortality from Opioid Overdose

Duska

2022

Matern Child Health J

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Introduction Maternal mortality rates have been increasing in the United States for decades. For several years, opioid overdoses have been a leading cause of maternal mortality in several states. New Hampshire (NH) is a particularly severe case, with 50% of all maternal deaths being caused by drug-related overdoses from 2016 to 2017. We report on the implementation of a point-of-care naloxone distribution program for an Ob/Gyn clinic in NH. Methods Naloxone distribution was tracked to measure program implementation. Proportion of patients screened for naloxone need was calculated monthly. Proportion of patients with which discussions about naloxone took place was calculated quarterly. Patient and provider perspectives on the program were captured periodically. Statistical process control charts monitored change over time and evaluated for special-cause variation. ResultsThe clinic has distributed 12 doses of naloxone since program implementation in April 2020. Despite the challenges posed by the COVID-19 pandemic, screening for naloxone need has remained at pre-pandemic rates (moving average: 73%), except for a decrease in April-May 2020. Patient-provider discussions about naloxone have also remained at pre-pandemic rates (moving average: 51%). Qualitative feedback from patients and providers has indicated that the program has been well-received by both groups. Discussion The purpose of this description is to provide a framework for other Ob/Gyn clinics to use in implementing similar naloxone distribution programs. Although too early to determine whether this intervention will result in a significant decrease in maternal mortality due to opioid overdose in our patients, this measure will continue to be tracked annually. Implementation of a naloxone program in the obstetrical context provides an important way to improve outcomes for a vulnerable perinatal population.

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Pregnancy-Associated Deaths in Virginia Due to Homicides, Suicides, and Accidental Overdoses Compared With Natural Causes

Cited by 17 publications

References 35 publications

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

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

Intimate Partner Violence, Firearm Violence, and Human Rights in the United States

Implementation of a Prenatal Naloxone Distribution Program to Decrease Maternal Mortality from Opioid Overdose

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