Friday, June 14, 2019

Drugs, Suicide Among Leading Causes of Postpartum Death in California, Study Finds

Drug-related deaths are second only to deaths from obstetric complications among women in California who die within a year of giving birth, a study in the American Journal of Obstetrics and Gynecology has found. Suicide ranked seventh as a cause of death in this population.

Sidra Goldman-Mellor, Ph.D., of the University of California, Merced, and Claire E. Margerison, Ph.D., of Michigan State University analyzed the health records of more than 1 million women who delivered a living infant in California hospitals between 2010 and 2012. They found that in that period, 300 women died within a year of giving birth and that drug-related causes and suicide together were responsible for roughly 1 in 6 of those deaths. Other causes of death in the women included circulatory system disease, cancer, other unintentional injuries, and homicide.

Three-fourths of the women who died from drug-related causes or suicide had visited an emergency department (ED) or hospital at least once between giving birth and dying—a finding that suggests an opportunity for screening, Goldman-Mellor and Margerison wrote.

“This observation suggests that ED and hospital visits may serve as a point of identification of—and eventually, intervention [for]—women at risk for postpartum death. Although examining details of these visits was beyond the scope of this study, this finding warrants further exploration in other samples, including examining the nature of these interactions to identify predictors of maternal death and/or points of intervention,” they wrote.

The researchers also found that although black women had the highest overall rate of postpartum death, non-Hispanic white women and women whose delivery costs were covered by Medicaid or paid by the patient had an elevated risk of drug-related death or suicide.

In discussing the limitations of their study, the study authors stated that data from California may not apply to the entire nation and called for further research.

“An important first step would be further documentation of this problem across the U.S., which will require that all state Maternal Mortality Review Committees (MMRCs) categorize deaths due to drugs, suicide, and other non-obstetric causes as medical deaths that fall within the scope of their review, particularly in [the] wake of congressional legislation providing funding for all states to form MMRCs,” they wrote.

For related information, see the Psychiatric News article “Is Postpartum Depression a Unique Psychiatric Disorder?” and the Psychiatric Services article “Use of Text Messaging for Postpartum Depression Screening and Information Provision.”

(Image: iStock/Halfpoint)


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