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Abstract
Objective Rates of death due to homicide, suicide and overdose during pregnancy and the first year postpartum have increased substantially in the USA in recent years. The aims of this study were to use 2018–2019 data on deaths identified for review by the North Carolina Maternal Mortality Review Committee (NC-MMRC), data from the North Carolina Violent Death Reporting System (NC-VDRS) and data from the Statewide Unintentional Drug Overdose Reporting System (NC-SUDORS) to examine homicide, suicide and unintentional opioid-involved overdose deaths during pregnancy and the first year postpartum.
Methods We linked data from the 2018–2019 NC-MMRC to suicide and homicide deaths among women ages 10–50 years from the 2018–2019 NC-VDRS and to unintentional opioid-involved overdose deaths among women ages 10–50 years from the 2018–2019 NC-SUDORS. We conducted descriptive analyses to examine the prevalence of demographic characteristics and the circumstances surrounding each cause of death.
Results From 2018 to 2019 in North Carolina, there were 23 homicides, nine suicides and 36 unintentional opioid-involved overdose deaths (9.7, 3.8 and 15.1 per 100 000 live births, respectively) during pregnancy and the first year postpartum. Most homicide deaths (87.0%) were by firearm, and more than half (52.5%) were related to intimate partner violence. More than two-thirds of women who died by suicide had a current mental health problem (77.8%). Less than one-fourth (22.2%) of those who died by unintentional opioid-involved overdose had a known history of substance use disorder treatment.
Conclusion Our approach to quantifying and describing these causes of pregnancy-associated death can serve as a framework for other states to inform data-driven prevention.
- Violence
- Suicide/Self?Harm
- Poisoning
- Descriptive Epidemiology
- Mortality
- Gender
Data availability statement
Data may be obtained from a third party and are not publicly available. Data can be requested from the North Carolina Division of Public Health.
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Data availability statement
Data may be obtained from a third party and are not publicly available. Data can be requested from the North Carolina Division of Public Health.
Footnotes
Twitter @AnnaEAustin
Funding This work was supported by an award from the Centers for Disease Control and Prevention, National Center for Injury Prevention and Control to the North Carolina Division of Public Health (Overdose Data to Action, cooperative agreement #5NU17CE925024-02-00). Authors from the University of North Carolina at Chapel Hill were funded through a subcontract under this grant (contract #42469).
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Provenance and peer review Not commissioned; externally peer reviewed.
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