Enhanced Surveillance for Pregnancy-Associated Mortality—Maryland, 1993-1998

Abstract

In this Maryland sample, comprehensive identification of pregnancy-associated deaths was accomplished only after collecting information from multiple sources and including all deaths occurring up to 1 year after delivery or pregnancy termination. This enhanced pregnancy mortality surveillance led to the disturbing finding that a pregnant or recently pregnant woman is more likely to be a victim of homicide than to die of any other cause. By broadening pregnancy mortality to include all possible causes, previously neglected factors may assume increased importance in prenatal and postpartum care.

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

“…Results from this study support those from multiple studies on violence and maternal health in which homicide was identified as a leading cause of pregnancy-associated deaths among pregnant or postpartum women in the United States, including studies or reviews that were conducted in Maryland, Massachusetts, Cook County, Illinois, the District of Columbia, New York City, and North Carolina (Chang et al, 2005;Cheng & Horon, 2010;Dannenberg et al, 1995;Fildes et al, 1992;Horon & Cheng, 2001;Krulewitch et al, 2001;Nannini, Weiss, Goldstein, & Fogerty, 2002;Parsons & Harper, 1999). It also supports evidence that DV is a risk factor for pregnancy-associated deaths due to violence.…”

The Furor Over Maternal Homicide

“…That link is a limitation of Krulewitch et al (2003), in which adolescent homicide victims were 3.7 times more likely to be pregnant when compared with adult homicide victims. Although the comparison group in Horon and Cheng's (2001) study was younger than the nonpregnant control group, they found that the adjustment for maternal age did not explain the higher proportion of deaths among the pregnant group. Both of the aforementioned studies suggest the importance of controlling for demographic factors when conducting research on pregnancy and homicide.…”

Pregnancy associated death in record linkage studies relative to delivery, termination of pregnancy, and natural losses: A systematic review with a narrative synthesis and meta-analysis

“…In other words, they lacked any data on deaths associated with pregnancy losses. The distribution by country of these studies was as follows: one in Bangladesh, 28 one in Brazil, 29 two in Canada, 30,31 one in Denmark, 32 one in Italy, 33 three in Netherlands, 34–36 four in Sweden, 37–39 one in Taiwan, 40 six in the United Kingdom, 41–46 thirty-four in the United States including Puerto Rico, 47–79 and three reporting data from multiple countries for which at least one country’s data used record linkage which met our criteria for inclusion. 80–82…”