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Preventing Pregnancy-Related Mental Health Deaths: Insights From 14 US Maternal Mortality Review Committees, 2008-17

Journal

HEALTH AFFAIRS
Volume 40, Issue 10, Pages 1551-1559

Publisher

PROJECT HOPE
DOI: 10.1377/hlthaff.2021.00615

Keywords

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Funding

  1. Merck
  2. Department of Energy
  3. CDC.
  4. CDC
  5. Perigee
  6. PCORI [IHS-2019C2-17367, MAT-2018C2-12891]
  7. Substance Abuse and Mental Health Services Administration [1H79SM082771-01]
  8. ACOG [6 NU380T000287-02-01]
  9. National Institute of Mental Health [2R42 MH113381-02]
  10. CDC [5U01DP006093-05]
  11. Perigee Fund Grant agreement
  12. Massachusetts Department of Mental Health
  13. American College of Obstetricians and Gynecologists (ACOG)
  14. National Institutes of Health
  15. Patient-Centered Outcomes Research Institute (PCORI)

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Approximately 700 people die in the United States each year from pregnancy-related complications. Among these deaths, 11% are attributed to mental health conditions, with a higher likelihood of being preventable, affecting non-Hispanic White individuals, and occurring within 43-365 days postpartum.
Each year approximately 700 people die in the United States from pregnancy-related complications. We describe the characteristics of pregnancy-related deaths due to mental health conditions, including substance use disorders, and identify opportunities for prevention based on recommendations from fourteen state Maternal Mortality Review Committees (MMRCs) from the period 2008-17. Among 421 pregnancy-related deaths with an MMRC-determined underlying cause of death, 11 percent were due to mental health conditions. Pregnancy-related mental health deaths were more likely than deaths from other causes to be determined by an MMRC to be preventable (100 percent versus 64 percent), to occur among non-Hispanic White people (86 percent versus 45 percent), and to occur 43-365 days postpartum (63 percent versus 18 percent). Sixty-three percent of pregnancy-related mental health deaths were by suicide. Nearly three-quarters of people with a pregnancy-related mental health cause of death had a history of depression, and more than two-thirds had past or current substance use. MMRC recommendations can be used to prioritize interventions and can inform strategies to enable screening, care coordination, and continuation of care throughout pregnancy and the year postpartum.

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