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CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
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Poster Session 3

(881) Circumstances and Trends of Pregnancy-Associated Suicides in the United States from 2018 to 2021

Friday, January 31, 2025
10:30 AM – 12:30 PM  

    Submitting Author and Presenting Author(s)

  • Qing Li, MD, DrPH

    Independent Researcher
    Denver, CO, United States

    • Coauthor(s)

  • Emily S. Miller, MD, MPH (she/her/hers)

    Associate Professor
    Women & Infants Hospital of Rhode Island and Alpert Medical School of Brown University
    Providence, Rhode Island, United States

  • Sarah G. Obican, MD

    Associate Professor
    Department of Obstetrics and Gynecology, University of South Florida
    Tampa, Florida, United States

  • DR

    Daniel Romer, PhD

    Professor and Research Director
    Annenberg Public Policy Center, University of Pennsylvania
    Philadelphia, Pennsylvania, United States

Objective:

Pregnancy-associated suicide is a common cause of maternal mortality in the US. Our objective was to investigate the trends and occurrence of circumstances surrounding pregnancy-associated suicide before and during the COVID-19 pandemic, with a specific focus on understanding its relationship with intimate partner adversity (IPA).

Study Design:

In a cross-sectional study, we analyzed 315 pregnancy-associated suicide incidents from 34 states, the District of Columbia, and Puerto Rico with complete case reporting (Figure) in the 2018-2021 National Violent Death Reporting System, which is a national surveillance system for violent death and the largest dataset on suicide decedents. Information was captured by standardized coding in death certificates, records from coroner and medical examiners and law enforcement, and toxicology reports. IPA was defined as a divorce, breakup, argument, jealousy, conflict, or violence among intimate partners, which appeared to have contributed to suicide. The characteristics of the victim, incident, and circumstances were compared, stratified by the presence of documented IPA, using bivariate analyses.

Results:

Pregnancy-associated suicide counts decreased 12.5% from 168 (2018-2019) to 147 (2020-2021). Half died between 43 to 365 days postpartum (Table). Firearms were the primary lethal means (41%) followed by hanging, strangulation, or suffocation (40%). Among 315 cases, 63% were White, 60% had a previously identified mental health condition (MHC), and 46% had IPA. Compared to cases without IPA, IPA-involved cases did not vary by the presence of MHC or injury location (p >0.05) but were more likely to involve a suicide following the homicide (p=0.04) and alcohol use (p=0.02).

Conclusion:

Pregnancy-associated suicide decreased from two years before to two years during the pandemic in the US. MHC, IPA, and firearm use were common. Policies and programs to screen and respond to MHC, firearm use, IPA and violence among women of reproductive age may be beneficial public health strategies to prevent pregnancy-associated suicide.