Pregnant Or Recently Pregnant Women More Likely To Die From Homicide Than Any Other Cause.

2001 APR 5 - (NewsRx.com & NewsRx.net) -- Using an enhanced data collection method, researchers have found that women residing in Maryland who are pregnant or recently pregnant are more likely to die from homicide than from any other cause.

Isabelle L. Horon, DrPH, and Diana Cheng, MD, from the Maryland Department of Health and Mental Hygiene, Baltimore, used enhanced surveillance techniques to ascertain the number and causes of pregnancy-associated deaths that occurred in Maryland between 1993 and 1998. They used an expansion of the World Health Organization (WHO) definition of a maternal death to include deaths commonly associated with pregnancy, such as hemorrhage, pregnancy-induced hypertension, and embolism (blockage of an artery) which are captured in the WHO definition, as well as deaths not traditionally considered to be related to pregnancy, such as accidents, homicide, and suicide, occurring up to 365 days following termination of pregnancy.

Their findings were reported in the March 21, 2001, issue of the Journal of the American Medical Association.

Complete and accurate identification of all deaths associated with pregnancy is a critical first step in the prevention of such deaths, Horon et al. point out. "Deaths occurring among women who are pregnant or who have had a recent pregnancy have a devastating impact on the family and community. It is important to understand the magnitude and causes of pregnancy-associated mortality so that comprehensive strategies can be formulated to prevent such deaths," the researchers write.

Previous studies have shown that 50% or more of death records completed by physicians fail to report that a woman was pregnant or had a recent pregnancy, making reliance upon these records for accurate and comprehensive data collection inadequate. These death records are often used to determine which deaths were associated with a pregnancy.

The Maryland researchers collected data from three sources: 1) death certificates to identify those records on which a complication of pregnancy, childbirth, or the period after childbirth was listed as an underlying or contributing cause of death; 2) linkage of death certificates of reproductive-age women with corresponding live birth and fetal death records to identify a pregnancy within the year preceding death; and 3) review of medical examiner records for evidence of pregnancy.

Horon et al. identified 247 pregnancy-associated deaths (among women aged 14-44 years) in Maryland from 1993-1998. They found that homicide was the leading cause of death (50 deaths or 20% of deaths) and cardiovascular disorders were the second-leading cause (48 deaths or 19% of deaths).