Preventing Pregnancy-Related Mental Health Deaths: Insights From 14 US Maternal Mortality Review Committees, 2008–17

Trost, Susanna L.; Beauregard, Jennifer L.; Smoots, Ashley N.; Ko, Jean Y.; Haight, Sarah C.; Simas, Tiffany A. Moore; Byatt, Nancy; Madni, Sabrina A.; Goodman, David A.

doi:10.1377/hlthaff.2021.00615

Cited by 181 publications

(208 citation statements)

References 22 publications

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“…Furthermore, in 67% of these deaths due to mental health conditions, the woman had a history of or current substance use. All the pregnancy-related mental health deaths for which preventability could be determined (n = 37) were found to be preventable [60]. These results highlight the importance of mental health screenings for pregnant women and mothers and timely treatment during the perinatal period.…”

Section: Individual Factorsmentioning

confidence: 77%

“…Comorbid SUD and other mental health conditions (depressive and anxiety disorders) are also common in women of reproductive age [58], and there is often a bidirectional relationship with physical chronic conditions and illness [59]. A recent study that examined 2008-2017 Maternal Mortality Committee Review data from 14 states found that among 421 pregnancy-related deaths with determined causes, 11% were due to mental health conditions (with 63% of these due to suicide) [60]. Furthermore, in 67% of these deaths due to mental health conditions, the woman had a history of or current substance use.…”

Section: Individual Factorsmentioning

confidence: 99%

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A Critical Review on the Complex Interplay between Social Determinants of Health and Maternal and Infant Mortality

Dagher

Linares

2022

Children

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Background: U.S. maternal and infant mortality rates constitute an important public health problem, because these rates surpass those in developed countries and are characterized by stark disparities for racial/ethnic minorities, rural residents, and individuals with less privileged socioeconomic status due to social determinants of health (SDoH). Methods: A critical review of the maternal and infant mortality literature was performed to determine multilevel SDoH factors leading to mortality disparities with a life course lens. Results: Black mothers and infants fared the worst in terms of mortality rates, likely due to the accumulation of SDoH experienced as a result of structural racism across the life course. Upstream SDoH are important contributors to disparities in maternal and infant mortality. More research is needed on the effectiveness of continuous quality improvement initiatives for the maternal–infant dyad, and expanding programs such as paid maternity leave, quality, stable and affordable housing, and social safety-nets (Medicaid, CHIP, WIC), in reducing maternal and infant mortality. Finally, it is important to address research gaps in individual, interpersonal, community, and societal factors, because they affect maternal and infant mortality and related disparities. Conclusion: Key SDoH at multiple levels affect maternal and infant health. These SDoH shape and perpetuate disparities across the lifespan and are implicated in maternal and infant mortality disparities.

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Section: Individual Factorsmentioning

confidence: 77%

Section: Individual Factorsmentioning

confidence: 99%

A Critical Review on the Complex Interplay between Social Determinants of Health and Maternal and Infant Mortality

Dagher

Linares

2022

Children

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“…Israel reports a lower rate of 0.43 per 100,000 live births, or 3.6% of postpartum mortality [ 24 ], reasons for this being religion as a protective factor, or under-reporting of suicide due to mental health stigma. Trost et al [ 4 •] in reviewing pregnancy-related mental health deaths (including suicides and accidental overdoses) in 14 states, found that, 11% of pregnancy-related deaths were due to mental health conditions, and 63% of pregnancy-related mental health deaths were by suicide. Most (86%) of these deaths occurred in White people, which was a significant difference from the race and ethnicity distribution of pregnancy-related deaths from other causes [ 4 •].…”

Section: Prevalence Of Perinatal Suicide and Perinatal Suicidalitymentioning

confidence: 99%

“…Trost et al [ 4 •] in reviewing pregnancy-related mental health deaths (including suicides and accidental overdoses) in 14 states, found that, 11% of pregnancy-related deaths were due to mental health conditions, and 63% of pregnancy-related mental health deaths were by suicide. Most (86%) of these deaths occurred in White people, which was a significant difference from the race and ethnicity distribution of pregnancy-related deaths from other causes [ 4 •]. However, racial and ethnic differences in maternal mortality due to suicide can be difficult to evaluate; for example, American Indian/Alaska (AI/AN) maternal mortality data for homicide and suicide often include small samples and may categorize AI/AN maternal deaths in an ‘‘Other’’ race/ethnicity category [ 25 ].…”

Section: Prevalence Of Perinatal Suicide and Perinatal Suicidalitymentioning

confidence: 99%

“…Despite this drop across the world, in the USA, the maternal mortality ratio increased by 26.6% between 2000 and 2014 [ 3 ]. Although part of this increase is attributed to improved methods of identifying maternal deaths, maternal mortality rates in the USA are the highest among developed countries [ 3 ], and suicide is a leading cause of maternal mortality [ 4 •].…”

Section: Introductionmentioning

confidence: 99%

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Suicide and Maternal Mortality

Chin

Wendt

Bennett

et al. 2022

Curr Psychiatry Rep

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Purpose of Review Suicide is a leading cause of death in the perinatal period (pregnancy and 1 year postpartum). We review recent findings on prevalence, risk factors, outcomes, and prevention and intervention for suicide during pregnancy and the first year postpartum. Recent Findings Standardization of definitions and ascertainment of maternal deaths have improved identification of perinatal deaths by suicide and risk factors for perinatal suicide. Reports of a protective effect of pregnancy and postpartum on suicide risk may be inflated. Clinicians must be vigilant for risk of suicide among their perinatal patients, especially those with mental health diagnoses or prior suicide attempts. Summary Pregnancy and the year postpartum are a time of increased access to healthcare for many, offering many opportunities to identify and intervene for suicide risk. Universal screening for suicide as part of assessment of depression and anxiety along with improved access to mental health treatments can reduce risk of perinatal suicide.

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