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Pregnancy-Associated Death: A Qualitative Systematic Review of Homicide and Suicide

Shadigian, Elizabeth M. MD*; Bauer, Samuel T. MD

Obstetrical & Gynecological Survey: March 2005 - Volume 60 - Issue 3 - p 183-190
doi: 10.1097/01.ogx.0000155967.72418.6b

A systematic review of the literature on maternal homicide and suicide was performed to understand the causes of pregnancy-associated death. Forty-four studies examined homicide and/or suicide and pregnancy-associated death (defined as the death of a woman, from any cause, while she is pregnant or within 1 year of termination of pregnancy) (1). Of these studies, 747 homicides and 349 suicides were identified. All studies were included except duplicate datasets, case reports of less than 3 events, suicide attempts, unpublished manuscripts, review articles, or non-English studies. Homicide is a leading cause of pregnancy-associated death and suicide is also an important cause of death among pregnant and recently pregnant women. Healthcare providers should understand that homicide is a leading cause of pregnancy-associated death, most commonly as a result of partner violence. Therefore, screening for both partner violence and suicidal ideation are essential components of comprehensive medical care for women during and after pregnancy.

Target Audience: Obstetricians & Gynecologists, Family Physicians

Learning Objectives: After completion of this article, the reader should be able to define the term “pregnancy-associated death,” to summarize the literature on pregnancy-associated death, and to list the reasons for under-reporting of pregnancy associated deaths.

*Clinical Associate Professor and †House Officer, Department of Obstetrics and Gynecology, University of Michigan Health System, Ann Arbor, Michigan

Chief Editor’s Note: This article is part of a series of continuing education activities in this Journal through which a total of 36 AMA/PRA category 1 credit hours can be earned in 0. Instructions for how CME credits can be earned appear on the last page of the Table of Contents.

The authors have disclosed that they have no financial relationships with or interests in any commercial companies pertaining to this educational activity.

Reprint requests to: Elizabeth M. Shadigian, MD, Clinical Associate Professor, Department of Obstetrics and Gynecology, University of Michigan Health System, 1500 East Medical Center Drive, F4782 Mott, Box 0264, Ann Arbor, MI 48109. E-mail:

© 2005 Lippincott Williams & Wilkins, Inc.