BACKGROUND AND PURPOSE:

• Wallace et al. (Obstetrics & Gynecology, 2021) sought to determine the national pregnancy-associated homicide prevalence

METHODS:

• Population
  • Female decedents aged 10 to 44 in the US
  • Data derived from the National Center for health Statistics 2018 and 2019
• Study design
  • Pregnancy-associated homicide mortality was compared to homicide mortality among non-pregnant, non-postpartum women and direct maternal causes of death
  • Stratification performed by race/ethnicity and age         
• Outcomes
  • 2-year pregnancy-associated homicide mortality ratio (deaths/100,000 live births)
  • Comparative risk of homicide in the perinatal period (pregnancy and up to 1 year postpartum) vs nonpregnant, nonpostpartum females

RESULTS:

• 4705 homicide victims of reproductive age
• Homicide rate among women in the perinatal period was 16% higher than in non-pregnant, non-postpartum women (P<0.05)
  • Perinatal: 3.62 deaths per 100,000 live births
  • Non-pregnant, non-postpartum: 3.12 deaths per 100,000 population
• Homicide mortality ratios during pregnancy or within 42 days of the end of pregnancy exceeded hypertensive disorders, hemorrhage, and infection, by more than twofold
• Pregnancy was associated with a significantly elevated homicide risk among
  • Black women
  • Girls and younger women (age 10 to 24 years), across racial and ethnic subgroups
• Two thirds of the fatal injuries occurred in the home (64.8%), and most involved firearms (69.2%)

CONCLUSION:

• In the US, homicide is the leading cause of death for women in the perinatal period
• The authors state

Although this is important information for monitoring progress towards the elimination of pregnancy-associated homicide, information alone will do nothing to save lives

Already, increasing efforts within individual states have been devoted to identifying and reviewing maternal deaths due to violence to make recommendations at individual, community, system, and policy levels for the prevention of future cases

Although encouraging, a commitment to the actual implementation of policies and investments known to be effective at protecting and the promoting the health and safety of girls and women must follow

Learn More – Primary Sources:

Homicide During Pregnancy and the Postpartum Period in the United States, 2018–2019

Related ObG Topics:

Maternal Near-Misses: An Investigation of Incidence and Causes

Sepsis and Sepsis-Related Maternal Mortality in the U.S. – Does it Happen More Than We Think?

How Do Health Outcomes in the Richest Counties in the US Compare to Those of Average Citizens in Other Developed Nations?