Anna Wald, MD, MPH reviewing Metz TD et al. Obstet Gynecol 2016 Nov 3.

In a Colorado study, 30% of pregnancy-associated deaths were from suicide or accidental overdose.

Compared with other developed nations, the U.S. lags at reducing maternal mortality, despite promotion of collaborative guidelines addressing the most common causes of pregnancy-related catastrophes (e.g., NEJM JW Womens Health Aug 2015 and Obstet Gynecol 2015 Jul; 126:155). Moreover, accidental and incidental deaths are usually not included among maternal death counts. Investigators reviewed all pregnancy-associated deaths (those during pregnancy and first postpartum year) to identify deaths caused by suicide or overdose in Colorado from 2004 through 2012.

Of 211 maternal deaths, 63 (30%) resulted from suicide or accidental overdose. Just 6 of these deaths occurred during pregnancy. Prior psychiatric diagnoses were documented in 32 women, with depression the most common. Opioids (primarily prescription) were detected in the bodies of 24 of the 50 women with toxicology results. Among 27 women who were receiving psychiatric medications (mostly selective serotonin reuptake inhibitors [SSRIs]) prior to becoming pregnant, about half discontinued treatment during pregnancy (4 at the recommendation of their provider).

CITATION(S):

Metz TD et al. Maternal deaths from suicide and overdose in Colorado, 2004–2012. Obstet Gynecol 2016 Nov 3; [e-pub]. 

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