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Austin AE, Naumann RB, DiPrete BL, Geary S, Proescholdbell SK, Jones-Vessey K. Pregnancy-associated homicide, suicide and unintentional opioid-involved overdose deaths, North Carolina 2018-2019. Inj Prev 2024; 30:393-399. [PMID: 38195655 PMCID: PMC11231051 DOI: 10.1136/ip-2023-045112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 12/20/2023] [Indexed: 01/11/2024]
Abstract
OBJECTIVE Rates of death due to homicide, suicide and overdose during pregnancy and the first year postpartum have increased substantially in the USA in recent years. The aims of this study were to use 2018-2019 data on deaths identified for review by the North Carolina Maternal Mortality Review Committee (NC-MMRC), data from the North Carolina Violent Death Reporting System (NC-VDRS) and data from the Statewide Unintentional Drug Overdose Reporting System (NC-SUDORS) to examine homicide, suicide and unintentional opioid-involved overdose deaths during pregnancy and the first year postpartum. METHODS We linked data from the 2018-2019 NC-MMRC to suicide and homicide deaths among women ages 10-50 years from the 2018-2019 NC-VDRS and to unintentional opioid-involved overdose deaths among women ages 10-50 years from the 2018-2019 NC-SUDORS. We conducted descriptive analyses to examine the prevalence of demographic characteristics and the circumstances surrounding each cause of death. RESULTS From 2018 to 2019 in North Carolina, there were 23 homicides, nine suicides and 36 unintentional opioid-involved overdose deaths (9.7, 3.8 and 15.1 per 100 000 live births, respectively) during pregnancy and the first year postpartum. Most homicide deaths (87.0%) were by firearm, and more than half (52.5%) were related to intimate partner violence. More than two-thirds of women who died by suicide had a current mental health problem (77.8%). Less than one-fourth (22.2%) of those who died by unintentional opioid-involved overdose had a known history of substance use disorder treatment. CONCLUSION Our approach to quantifying and describing these causes of pregnancy-associated death can serve as a framework for other states to inform data-driven prevention.
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Affiliation(s)
- Anna E Austin
- Department of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Rebecca B Naumann
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Bethany L DiPrete
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Shana Geary
- Injury and Violence Prevention Branch, North Carolina Division of Public Health, Raleigh, North Carolina, USA
| | - Scott K Proescholdbell
- Injury and Violence Prevention Branch, North Carolina Division of Public Health, Raleigh, North Carolina, USA
| | - Kathleen Jones-Vessey
- North Carolina Department of Health and Human Services, Raleigh, North Carolina, USA
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Bright M, Amendola A, Roussos-Ross D. Maternal Mortality Review Committees should take a closer look at homicide deaths. Am J Obstet Gynecol 2024; 231:143-146. [PMID: 38565477 DOI: 10.1016/j.ajog.2024.02.296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 02/09/2024] [Accepted: 02/26/2024] [Indexed: 04/04/2024]
Affiliation(s)
- Melissa Bright
- Center for Violence Prevention Research, Gainesville, FL.
| | | | - Dikea Roussos-Ross
- Department of Obstetrics and Gynecology, University of Florida, Gainesville, FL
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Dang LN, Kahsay ET, James LN, Johns LJ, Rios IE, Mezuk B. Research utility and limitations of textual data in the National Violent Death Reporting System: a scoping review and recommendations. Inj Epidemiol 2023; 10:23. [PMID: 37161610 PMCID: PMC10170777 DOI: 10.1186/s40621-023-00433-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 04/26/2023] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND Many studies of injury deaths rely on mortality data that contain limited contextual information about decedents. The National Violent Death Reporting System (NVDRS) is unique among such data systems in that each observation includes both quantitative variables and qualitative texts (called "narratives") abstracted from original source documents. These narratives provide rich data regarding salient circumstances that can be used to inform prevention efforts. This review provides a comprehensive summary of peer-reviewed research using NVDRS narratives over the past 20 years, including the limitations of these texts and provides recommendations on utilizing and improving narrative quality for researchers and practitioners. MAIN BODY Studies that used narratives to examine deaths related to suicide, homicide, undetermined intent, accidental firearm, or legal intervention were identified by a title/abstract screening, followed by a full-text review. The search was conducted on English-language, peer-reviewed literature and government reports published from 2002 to 2022 in PubMed, PsycInfo, Scopus, and Google Scholar. Abstracted elements focused on the methodologies used to analyze the narratives, including approaches to explore potential biases in these texts. Articles were abstracted independently by two reviewers, with disagreements resolved through consensus discussion. During the 20-year period, 111 articles used narratives. Two-thirds studied suicide (n = 48, 43%) and homicides (n = 25, 23%). Most studies analyzed the narratives using manual review (n = 81, 73%) and keyword searches (n = 9, 8%), with only 6 (5%) using machine learning tools. Narratives were mainly used for case finding (n = 49, 44%) and characterization of circumstances around deaths (n = 38, 34%). Common challenges included variability in the narratives and lack of relevant circumstantial details for case characterization. CONCLUSION Although the use of narratives has increased over time, these efforts would be enhanced by detailed abstraction of circumstances with greater salience to injury research and prevention. Moreover, researchers and practitioners would benefit from guidance on integrating narratives with quantitative variables and standardized approaches to address variability in the completeness and length of narratives. Such efforts will increase the reliability of findings and set the stage for more widespread applications of data science methods to these texts.
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Affiliation(s)
- Linh N Dang
- Department of Epidemiology, Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - Eskira T Kahsay
- Department of Epidemiology, Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - LaTeesa N James
- Taubman Health Sciences Library, University of Michigan, Ann Arbor, MI, USA
| | - Lily J Johns
- Department of Epidemiology, Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - Isabella E Rios
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Briana Mezuk
- Department of Epidemiology, Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA.
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Delker E, Marienfeld C, Baer RJ, Parry B, Kiernan E, Jelliffe-Pawlowski L, Chambers C, Bandoli G. Adverse Perinatal Outcomes and Postpartum Suicidal Behavior in California, 2013-2018. J Womens Health (Larchmt) 2023; 32:608-615. [PMID: 36867753 PMCID: PMC10171948 DOI: 10.1089/jwh.2022.0255] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2023] Open
Abstract
Background: The objectives of this study were to describe trends in the prevalence of postpartum suicidal behaviors in California, 2013-2018, and to estimate associations between adverse perinatal outcomes and suicidal behaviors. Materials and Methods: We used data from a population-based cohort derived from all birth and fetal death certificates. Records were individually linked to maternal hospital discharge records for the years before and after delivery. We estimated the prevalence of postpartum suicidal ideation and attempt by year. Then, we estimated crude and adjusted associations between adverse perinatal outcomes and these suicidal behaviors. The sample included 2,563,288 records. Results: The prevalence of postpartum suicidal ideation and attempt increased from 2013 to 2018. People with postpartum suicidal behavior were younger, had less education, and were more likely to live in rural areas. A greater proportion of those with postpartum suicidal behavior were Black and publicly insured. Severe maternal morbidity, neonatal intensive care unit admission, and fetal death were associated with greater risk of ideation and attempt. Major structural malformation was not associated with either outcome. Conclusions: The burden of postpartum suicidal behavior has increased over time and is unequally distributed across population subgroups. Adverse perinatal outcomes may help identify individuals that could benefit from additional care during the postpartum period.
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Affiliation(s)
- Erin Delker
- Department of Pediatrics and University of California, San Diego (UCSD), La Jolla, California, USA
| | - Carla Marienfeld
- Department of Psychiatry, University of California, San Diego (UCSD), La Jolla, California, USA
| | - Rebecca J. Baer
- Department of Pediatrics and University of California, San Diego (UCSD), La Jolla, California, USA
| | - Barbara Parry
- Department of Psychiatry, University of California, San Diego (UCSD), La Jolla, California, USA
| | - Elizabeth Kiernan
- Department of Pediatrics and University of California, San Diego (UCSD), La Jolla, California, USA
| | - Laura Jelliffe-Pawlowski
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
- California Preterm Birth Initiative, University of California San Francisco, San Francisco, California, USA
| | - Christina Chambers
- Department of Pediatrics and University of California, San Diego (UCSD), La Jolla, California, USA
| | - Gretchen Bandoli
- Department of Pediatrics and University of California, San Diego (UCSD), La Jolla, California, USA
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Kozhimannil KB, Lewis VA, Interrante JD, Chastain PL, Admon L. Screening for and Experiences of Intimate Partner Violence in the United States Before, During, and After Pregnancy, 2016-2019. Am J Public Health 2023; 113:297-305. [PMID: 36701660 PMCID: PMC9932386 DOI: 10.2105/ajph.2022.307195] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2022] [Indexed: 01/27/2023]
Abstract
Objectives. To measure rates of intimate partner violence (IPV) screening during the perinatal period among people experiencing physical violence in the United States. Methods. We used 2016-2019 Pregnancy Risk Assessment Monitoring System data (n = 158 338) to describe the incidence of physical IPV before or during pregnancy. We then assessed the prevalence of IPV screening before, during, or after pregnancy and predictors of receiving screening among those reporting violence. Results. Among the 3.5% (n = 6259) of respondents experiencing violence, 58.7%, 26.9%, and 48.3% were not screened before, during, or after pregnancy, respectively. Those reporting Medicaid or no insurance at birth, American Indian/Alaska Native people, and Spanish-speaking Hispanic people faced increased risk of not having a health care visit during which screening might occur. Among those attending a health care visit, privately insured people, rural residents, and non-Hispanic White respondents faced increased risk of not being screened. Conclusions. Among birthing people reporting physical IPV, nearly half were not screened for IPV before or after pregnancy. Public health efforts to improve maternal health must address both access to care and universal screening for IPV. (Am J Public Health. 2023;113(3):297-305. https://doi.org/10.2105/10.2105/AJPH.2022.307195).
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Affiliation(s)
- Katy B Kozhimannil
- Katy B. Kozhimannil, Julia D. Interrante, and Phoebe L. Chastain are with the University of Minnesota School of Public Health, Minneapolis. Valerie A. Lewis is with the University of North Carolina at Chapel Hill. Lindsay Admon is with the University of Michigan Institute for Healthcare Policy and Innovation, Ann Arbor
| | - Valerie A Lewis
- Katy B. Kozhimannil, Julia D. Interrante, and Phoebe L. Chastain are with the University of Minnesota School of Public Health, Minneapolis. Valerie A. Lewis is with the University of North Carolina at Chapel Hill. Lindsay Admon is with the University of Michigan Institute for Healthcare Policy and Innovation, Ann Arbor
| | - Julia D Interrante
- Katy B. Kozhimannil, Julia D. Interrante, and Phoebe L. Chastain are with the University of Minnesota School of Public Health, Minneapolis. Valerie A. Lewis is with the University of North Carolina at Chapel Hill. Lindsay Admon is with the University of Michigan Institute for Healthcare Policy and Innovation, Ann Arbor
| | - Phoebe L Chastain
- Katy B. Kozhimannil, Julia D. Interrante, and Phoebe L. Chastain are with the University of Minnesota School of Public Health, Minneapolis. Valerie A. Lewis is with the University of North Carolina at Chapel Hill. Lindsay Admon is with the University of Michigan Institute for Healthcare Policy and Innovation, Ann Arbor
| | - Lindsay Admon
- Katy B. Kozhimannil, Julia D. Interrante, and Phoebe L. Chastain are with the University of Minnesota School of Public Health, Minneapolis. Valerie A. Lewis is with the University of North Carolina at Chapel Hill. Lindsay Admon is with the University of Michigan Institute for Healthcare Policy and Innovation, Ann Arbor
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