Maternal deaths due to homicide and other injuries in North Carolina: 1992-1994.
OBJECTIVE
To determine the role of homicide and other injuries in maternal deaths in North Carolina over the three-year period from 1992 through 1994.


METHODS
Maternal deaths were identified from death certificates that indicated a maternal death and through an enhanced surveillance system that matches death certificates with live-birth and fetal-death certificates. Deaths were classified as direct, indirect, medically unrelated, or injury-related. Patterns of prenatal care were ascertained from the matching live-birth or fetal-death certificates. Maternal death rates for whites and nonwhites were calculated.


RESULTS
The most common cause of maternal death was injury, accounting for 62 of the 167 deaths (37%). Homicide was the most common cause of injury-related death (35.5%). The relative risk of maternal death for nonwhites compared with whites was 1.8 (95% confidence interval [CI] 1.6, 2.1). Similarly, their relative risk for injury-related maternal death was 1.7 (95% CI 1.4, 2.2).


CONCLUSIONS
It is essential to include an analysis of injury-related deaths in maternal mortality reporting. As the most common cause of maternal deaths, injury is not limited to densely populated, metropolitan areas. Counseling regarding injury prevention, domestic violence, and depression should be a part of both prenatal and postpartum care.
Harper
M
M
Wake Forest University, Bowman Gray School of Medicine, Winston-Salem, North Carolina, USA.
Parsons
L
L
D000328:Adult; D002423:Cause of Death / Q000639:trends*; D003644:Death Certificates; D005260:Female; D006708:Homicide / Q000517:prevention & control / Q000706:statistics & numerical data / Q000639:trends*; D006801:Humans; D017533:Marital Status; D008428:Maternal Mortality / Q000639:trends*; D009657:North Carolina / Q000453:epidemiology; D011159:Population Surveillance; D011295:Prenatal Care; D044469:Racial Groups; D012306:Risk; D012307:Risk Factors; D014947:Wounds and Injuries / Q000401:mortality* / Q000517:prevention & control