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Abstract
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OBJECTIVE: To analyze differences in the demographic and social factors associated with pregnancy-associated violent deaths due to homicide compared with suicide by pregnancy timing.
METHODS: This was a retrospective cohort study using the Centers for Disease Control and Prevention's National Violent Death Reporting System from 2008 to 2019. We included females aged 15-44 years who died by suicide, defined as intentional self-harm, or homicide. Pregnancy-associated deaths were defined as those that occurred during or within 1 year of pregnancy.
RESULTS: Of 38,417 female victims aged 15-44 years identified in the data set, 10,411 had known pregnancy status; 1,300 of those deaths were pregnancy associated. Of all deaths with known pregnancy status, 3,203 were by homicide (30.8%) and 7,208 (69.2%) were by suicide. Pregnancy-associated homicide deaths made up 20.6% of all homicide deaths, and pregnancy-associated suicide deaths made up 8.8% of all suicide deaths. Individuals who died by homicide were younger (29.4±8.2 years vs 31.5±8.6 years), more likely to be single or never married (61.0% vs 50.0%), and had a higher proportion of associate's degree-level education or less as compared with individuals who died by suicide (28.1% vs 43.9%). Of individuals who died by homicide, 37.7% were Black or African American, 13.4% were Hispanic, and 56.0%% were White. In comparison, 6.9% of individuals who died by suicide were Black or African American, 8.0% were Hispanic, and 85.0% were White. Having a mental health problem and any substance use were significantly more often associated with suicide deaths compared with homicide deaths (77.4% vs 7.2%, P<.001 for mental health, 33.3% vs 12.8%, P<.001 for substance use, respectively). Intimate partner violence was prevalent in both groups, although significantly higher in homicide deaths (57.3% vs 37.1%, P<.001). This pattern persisted when stratified by pregnancy status.
CONCLUSION: Mental health problems, substance use disorder, and intimate partner violence are preceding circumstances to pregnancy-associated suicide and homicide.
Language: en |