title: Deaths From Unintentional Injury, Homicide, and Suicide During or Within 1 Year of Pregnancy in Philadelphia.
abstract: OBJECTIVE
  To understand the effect of unintentional injuries (e.g., drug overdose), suicide, and homicide on pregnancy-associated death (death during or within 1 year of pregnancy).
  
  
  METHODS
  We analyzed all cases of pregnancy-associated death among Philadelphia, Pennsylvania, residents from 2010 to 2014, examining cause of death, contributing factors, and history of health care use.
  
  
  RESULTS
  Approximately half (49%; 42 of 85) of pregnancy-associated deaths were from unintentional injuries (n = 31), homicide (n = 8), or suicide (n = 3); drug overdose was the leading cause (n = 18). Substance use was noted during or around events leading to death in 46% (31 of 67) of nonoverdose deaths. A history of serious mental illness was noted in 39% (32 of 82) of nonsuicide deaths. History of intimate partner violence (IPV) was documented in 19% (15 of 77) of nonhomicide deaths. Regardless of cause of death, approximately half of all decedents had an unscheduled hospital visit documented within a month of death.
  
  
  CONCLUSIONS
  Unintentional injury, homicide, and suicide contribute to many deaths among pregnant and recently pregnant women. Interventions focused on substance use, mental health, and IPV may reduce pregnancy-associated and pregnancy-related deaths.
authors.affiliation: Pooja K. Mehta and Marcus A. Bachhuber are with Robert Wood Johnson Clinical Scholars Program, Department of Veterans Affairs, Philadelphia, PA.Roy Hoffman is with Fatality Review Program, Philadelphia Department of Public Health, Philadelphia.Sindhu K. Srinivas is with Department of Obstetrics and Gynecology, University of Pennsylvania Perelman School of Medicine, Philadelphia.
authors.forename: Pooja K
authors.initials: PK
authors.lastname: Mehta
authors.affiliation: Pooja K. Mehta and Marcus A. Bachhuber are with Robert Wood Johnson Clinical Scholars Program, Department of Veterans Affairs, Philadelphia, PA.Roy Hoffman is with Fatality Review Program, Philadelphia Department of Public Health, Philadelphia.Sindhu K. Srinivas is with Department of Obstetrics and Gynecology, University of Pennsylvania Perelman School of Medicine, Philadelphia.
authors.forename: Marcus A
authors.initials: MA
authors.lastname: Bachhuber
authors.affiliation: Pooja K. Mehta and Marcus A. Bachhuber are with Robert Wood Johnson Clinical Scholars Program, Department of Veterans Affairs, Philadelphia, PA.Roy Hoffman is with Fatality Review Program, Philadelphia Department of Public Health, Philadelphia.Sindhu K. Srinivas is with Department of Obstetrics and Gynecology, University of Pennsylvania Perelman School of Medicine, Philadelphia.
authors.forename: Roy
authors.initials: R
authors.lastname: Hoffman
authors.affiliation: Pooja K. Mehta and Marcus A. Bachhuber are with Robert Wood Johnson Clinical Scholars Program, Department of Veterans Affairs, Philadelphia, PA.Roy Hoffman is with Fatality Review Program, Philadelphia Department of Public Health, Philadelphia.Sindhu K. Srinivas is with Department of Obstetrics and Gynecology, University of Pennsylvania Perelman School of Medicine, Philadelphia.
authors.forename: Sindhu K
authors.initials: SK
authors.lastname: Srinivas
mesh_terms: D000059:Accidents / Q000401:mortality*; D000328:Adult; D002423:Cause of Death / Q000639:trends; D016208:Databases, Factual; D005260:Female; D006708:Homicide / Q000639:trends*; D006801:Humans; D015143:Philadelphia / Q000453:epidemiology; D011247:Pregnancy; D013405:Suicide / Q000639:trends*; D055815:Young Adult