BACKGROUND
Recent reports indicate that the contribution of deaths related to suicide and overdose
are increasing, and may be the leading contributors to maternal mortality up to one
year postpartum.
OBJECTIVE
This study aimed to provide a granular assessment of maternal deaths due to suicide
or drug overdose in the state of Michigan from 2008 to 2018.
STUDY DESIGN
This retrospective study involved a secondary review of deceased patients’ records
from 2008 to 2018 stored at the Michigan Department of Health and Human Services through
the Michigan Maternal Mortality Surveillance Program. Pregnancy-related and pregnancy-associated
deaths were reviewed. A descriptive analysis of maternal characteristics and identified
trends was presented in deidentified aggregate form.
RESULTS
There were 237 maternal deaths due to suicide or overdose from 2008 to 2018 included
in the review. Overall, 70.9% had a documented psychiatric illness in their medical
chart, with 48.1% having ≥2 psychiatric illnesses. However, only 34.5% (58/168) of
these patients had documentation of taking psychotropic medication for their illness.
Of those who died because of accidental or indeterminate substance overdose, 71.1%
(138/194) had a known history of substance use disorder. Only 27.4% (43/157) of patients
with a documented substance use disorder received medication-assisted treatment. Of
those with substance overdose deaths, 42.9% had an opioid prescription, 44.3% had
a benzodiazepine prescription, and 32.5% had a prescription for both. Prescription
opioids were the most common substance found on postmortem toxicology report, and
of these patients, 45.9% had a physician-prescribed opioid.
CONCLUSION
Most pregnant individuals had documented significant risk factors for mental illness
or substance use disorder; however, very few had documented pharmacologic therapy
for their psychiatric or addiction illness. There is an urgent need to implement effective
multidisciplinary health system mitigation strategies that address pregnancy and its
intersection with behavioral health.
Key words
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Article info
Publication history
Published online: November 11, 2022
Accepted:
November 9,
2022
Received in revised form:
October 14,
2022
Received:
August 1,
2022
Footnotes
Source of work: Michigan Department of Health and Human Services (MDHHS), Michigan Maternal Mortality Surveillance Program.
The authors report no conflict of interest.
The authors report no funding for this study.
Cite this article as: Kountanis JA, Roberts M, Admon LK, et al. Maternal deaths due to suicide and overdose in the state of Michigan from 2008 to 2018. Am J Obstet Gynecol MFM 2022;XX:x.ex–x.ex.
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