@article{ref1,
title="Maternal drug-related death and suicide are leading causes of post-partum death in California",
journal="American journal of obstetrics and gynecology",
year="2019",
author="Goldman-Mellor, Sidra and Margerison, Claire E.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: Reducing maternal mortality is a priority in the U.S. and worldwide. Drug-related deaths and suicide may account for a substantial and growing portion of maternal deaths, yet information on the incidence of and sociodemographic variation in these deaths is scarce. <br><br>OBJECTIVE: We sought to examine incidence of drug-related and suicide deaths in the 12 months after delivery, including heterogeneity by sociodemographic factors. We also explored maternal decedents' healthcare utilization prior to death. STUDY DESIGN: This retrospective, population-based cohort study followed 1,059,713 women who delivered a live-born infant in California hospitals during 2010-2012 to ascertain maternal death. Analyses were conducted using statewide, all-payer, longitudinally-linked hospital and death data. <br><br>RESULTS: A total of 300 women died during follow-up, a rate of 28.33 deaths per 100,000 person-years (p-y). The leading cause of death was obstetric-related problems (6.52 per 100,000 p-y). Drug-related deaths were the second leading cause of death (3.68 per 100,000 p-y), and suicide was the 7th leading cause (1.42 per 100,000 p-y); together, these deaths comprised 18% of all maternal deaths. Non-Hispanic White women, Medicaid-insured women, and women residing in micropolitan areas were especially likely to die from drugs/suicide. Two-thirds of women who died, including 74% of those who died by drugs/suicide, made ≥1 emergency department or hospital visit between their delivery and death. <br><br>CONCLUSION: Deaths due to drugs and suicide are a major contributor to mortality in the post-partum period and warrant increased clinical attention, including recognition by physicians and Maternal Mortality Review Committees as a medical cause of death. Importantly, ED and inpatient hospital visits may serve as a point of identification of - and eventually, prevention for - women at risk for these deaths.<br><br>Copyright © 2019 Elsevier Inc. All rights reserved.<p /> <p>Language: en</p>",
language="en",
issn="0002-9378",
doi="10.1016/j.ajog.2019.05.045",
url="http://dx.doi.org/10.1016/j.ajog.2019.05.045"
}