Pregnancy-Associated Deaths Due to Drugs, Suicide, and Homicide in the United States, 2010-2019

Obstet Gynecol. 2022 Feb 1;139(2):172-180. doi: 10.1097/AOG.0000000000004649.

Abstract

Objective: To estimate the prevalence of pregnancy-associated deaths due to drugs, suicide, and homicide nationwide from 2010 to 2019.

Methods: Using U.S. death certificate records from 2010 to 2019 for 33 states plus the District of Columbia, we identified pregnancy-associated deaths using the pregnancy checkbox and International Classification of Diseases, Tenth Revision codes, calculated pregnancy-associated death ratios, and categorized deaths by cause, timing relative to pregnancy, race or ethnicity, and age.

Results: Of 11,782 pregnancy-associated deaths identified between 2010 and 2019, 11.4% were due to drugs, 5.4% were due to suicide, and 5.4% were due to homicide, whereas 59.3% were due to obstetric causes and the remaining 18.5% were due to other causes. Drug-related deaths, suicide, and homicide accounted for 22.2% of pregnancy-associated deaths. All three causes of death increased over the study period, with drug-related pregnancy-associated deaths increasing 190%. Homicide during pregnancy and drug-related deaths, suicides, and homicide in the late postpartum period (43-365 days) accounted for a larger proportion of all deaths in these time periods than the contribution of these causes to all deaths among females of reproductive age. Pregnant and postpartum people identified as non-Hispanic American Indian or Alaska Native were at highest risk of drug-related and suicide death, and people identified as non-Hispanic Black were at highest risk of homicide.

Conclusion: Deaths due to drug use, suicide, and homicide constitute more than one fifth of all deaths during pregnancy and the first year postpartum. Drug-related deaths and homicides have increased over the past decade. Substantial racial and ethnic inequities in these deaths exist.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Case-Control Studies
  • Female
  • Homicide / statistics & numerical data*
  • Humans
  • Pregnancy / statistics & numerical data*
  • Pregnancy Complications / mortality*
  • Substance-Related Disorders / mortality*
  • Suicide / statistics & numerical data*
  • United States / epidemiology
  • Young Adult