title: Use of a prenatal risk screen to predict maternal traumatic pregnancy-associated death: program and policy implications.
abstract: BACKGROUND
  Motor vehicle crashes, homicide, suicide, and drug abuse are among the leading causes of pregnancy-associated deaths. To prevent such deaths, identifying women for intervention is required. The universally offered Florida Healthy Start Prenatal Risk Screen was evaluated to identify women at increased risk for traumatic pregnancy-associated death.
  
  
  METHODS
  Florida's Enhanced Maternal Mortality Reporting Database for 1999 through 2005 was linked with Florida's Healthy Start Prenatal Risk Screen to identify traumatic pregnancy-associated death as the outcome. Distribution of Healthy Start risk scores among women who died were compared with the screened population. Traumatic death estimates per 100,000 births were drawn for each risk score, along with estimates of the relative risk (RR) of traumatic death for each score. The RR of women with scores greater than or equal to 4 were compared with the risk of women scoring 0 to 3.
  
  
  RESULTS
  Almost 20% of the 620,959 women who did not die of traumatic death had a risk score of 0, compared with only 3% of the 144 women who did die of traumatic death. As risk scores increased, the chance of traumatic deaths sharply increased. A woman with a score of 4 had 11.78 times (confidence interval [CI], 4.63-29.69) the risk of traumatic death compared with a woman with a risk score of 0.
  
  
  CONCLUSIONS
  The implementation of prenatal risk screening to identify women at increased risk for traumatic pregnancy-associated death would help to ensure that policies to reduce infant risk factors also address maternal risk factors.
authors: Department of Pathology, University of Florida, Gainesville, Florida 32610, USA.
authors: Nancy S
authors: NS
authors: Hardt
authors: Jessica
authors: J
authors: Eliazar
authors: Martha
authors: M
authors: Burt
authors: Rajeeb
authors: R
authors: Das
authors: William P
authors: WP
authors: Winter
authors: Heidi
authors: H
authors: Saliba
authors: Jeffrey
authors: J
authors: Roth
mesh_terms: D000328:Adult; D002423:Cause of Death; D005260:Female; D005431:Florida / Q000453:epidemiology; D006801:Humans; D063130:Maternal Death / Q000209:etiology*; D008428:Maternal Mortality; D011237:Predictive Value of Tests; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000401:mortality / Q000517:prevention & control*; D011295:Prenatal Care / Q000592:standards*; D011296:Prenatal Diagnosis / Q000379:methods*; D012189:Retrospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors