OBJECTIVE: To identify pregnancy-associated homicide cases and to estimate the proportion that were perpetrated by a current or former intimate partner.
METHODS: This was an analysis of pregnancy-associated homicides occurring from 1993 to 2008 among Maryland residents using linked birth and death certificates, medical examiner charts, police records, and news publications.
RESULTS: Homicides (n=110) were the leading cause of death during pregnancy and the first postpartum year. Women who were African American, younger than 25 years, and unmarried were at the highest risk for homicide. Firearms were the most common (61.8%) method of death. A current or former intimate partner was the perpetrator in 54.5% (n=60) of homicide deaths and a nonpartner in 31.8% (n=35). If the cases (n=15) in which the victim–offender relationship could not be identified are excluded, 63.2% of homicides were committed by an intimate partner. Compared with homicides in which the perpetrator was not an intimate partner, a significantly higher percentage (P<.05) of intimate-partner homicides occurred at home (66.7% compared with 28.6%), among women who had completed more than 12 years of education (23.3% compared with 5.7%), and who were married (28.3% compared with 8.6%). Intimate-partner homicides were most prevalent (25.0%) during the first 3 months of pregnancy and least prevalent during the first 3 months postpartum (5.0%).
CONCLUSION: The majority of pregnancy-associated homicides were committed by current or former intimate partners, most commonly during the first 3 months of pregnancy. Efforts to protect women from partners optimally should begin before conception or very early in pregnancy.
LEVEL OF EVIDENCE: III