Homicide and suicide during the perinatal period: findings from the National Violent Death Reporting System.
OBJECTIVE
To estimate the rates of pregnancy-associated homicide and suicide in a multistate sample from the National Violent Death Reporting System, to compare these rates with other causes of maternal mortality, and to describe victims' demographic characteristics.


METHODS
We analyzed data from female victims of reproductive age from 2003 to 2007. We identified pregnancy-associated violent deaths as deaths attributable to homicide or suicide during pregnancy or within the first year postpartum, and we calculated the rates of pregnancy-associated homicide and suicide as the number of deaths per 100,000 live births in the sample population. We used descriptive statistics to report victims' demographic characteristics and prevalence of intimate-partner violence.


RESULTS
There were 94 counts of pregnancy-associated suicide and 139 counts of pregnancy-associated homicide, yielding pregnancy-associated suicide and homicide rates of 2.0 and 2.9 deaths per 100,000 live births, respectively. Victims of pregnancy-associated suicide were significantly more likely to be older and white or Native American as compared with all live births in National Violent Death Reporting System states. Pregnancy-associated homicide victims were significantly more likely to be at the extremes of the age range and African American. In our study, 54.3% of pregnancy-associated suicides involved intimate partner conflict that appeared to contribute to the suicide, and 45.3% of pregnancy-associated homicides were associated with intimate-partner violence.


CONCLUSIONS
Our results indicate that pregnancy-associated homicide and suicide are important contributors to maternal mortality and confirm the need to evaluate the relationships between sociodemographic disparities and intimate-partner violence with pregnancy-associated violent death.
From the Department of Obstetrics and Gynecology, Education Discovery Institute, Georgia Health Sciences University, Augusta, Georgia; the Department of Emergency Medicine, Department of Family Medicine, University of Michigan, Ann Arbor, Michigan; the Department of Community-Public Health, School of Nursing, Johns Hopkins University, Baltimore, Maryland; and the Departments of Psychiatry and Family Medicine, University of Michigan, Ann Arbor, Michigan.
Christie Lancaster
CL
Palladino
Vijay
V
Singh
Jacquelyn
J
Campbell
Heather
H
Flynn
Katherine J
KJ
Gold
D000293:Adolescent; D000328:Adult; D002487:Centers for Disease Control and Prevention, U.S.; D005260:Female; D006708:Homicide / Q000706:statistics & numerical data*; D006801:Humans; D011247:Pregnancy / Q000706:statistics & numerical data*; D013179:Spouse Abuse; D013405:Suicide / Q000706:statistics & numerical data*; D014481:United States; D055815:Young Adult