Maternal deaths in Colorado: self-harm is the leading cause

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Takeaway

  • In Colorado, the majority of maternal deaths were due to accidental overdose and suicide; 90% of deaths occurred in the postpartum period.

Why this matters

  • Improved monitoring and psychiatric treatment is needed to reduce the death rate in the postpartum period.
  • Universal screening at prenatal, hospital, and postpartum visit may improve detection rates.  
Key results
  • 211 maternal deaths were recorded during the study period.
  • 30% of deaths were classified as "maternal death by self-harm (accidental overdose or suicide)".
  • The most common detected class of drugs were opioids.
  • History of drug abuse was documented in 16.9%, prior psychiatric diagnosis documented in 54.2%, and prior suicide attempt documented in 10.2% of records of women with maternal death.
  • In 22.0% no risk factors were documented.
Study design
  • Case study of all women with pregnancy-associated deaths (during pregnancy or 1 y postpartum) from self-harm in Colorado from 2004 to 2012.
  • Funding: Agency for Healthcare Research and Quality, the National Institutes of Health/National Center for Research Resources Colorado CTSI, the National Institute on Drug Abuse, and the National Institute on Child Health and Human Development. 
Limitations
  • Not all prenatal records were available.