Standardized Criteria for Review of Perinatal Suicides and Accidental Drug-Related Deaths.
Standardized Criteria for Review of Perinatal Suicides and Accidental Drug-Related Deaths.
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DOI：
10.1097/aog.0000000000003988
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发表时间：
2020-10
影响因子：
7.2
通讯作者：
Metz TD
中科院分区：
文献类型：
--
作者：
Smid MC;Maeda J;Stone NM;Sylvester H;Baksh L;Debbink MP;Varner MW;Metz TD
估计2013年至2014年（实施标准化标准前）和2015年至2016年（实施标准后）被归类为妊娠相关的意外药物相关死亡和自杀的比例。根据疾病控制和预防中心的妊娠相关死亡标准，犹他州围产期死亡率审查委员会开发了一个标准化的评估工具，以评估2015年开始的意外药物相关死亡和自杀。我们对2013年至2016年期间由犹他州围产期死亡率审查委员会评估的所有妊娠相关死亡（妊娠期间或产后1年内发生的任何原因）和妊娠相关死亡（直接归因于妊娠或产后事件）进行了回顾性病例审查。我们使用Fisher精确检验比较了标准化标准检查表工具实施前和实施后符合妊娠相关标准的意外药物相关死亡和自杀的比例。我们使用趋势检验评估了2013年至2014年和2015年至2016年犹他州妊娠相关死亡率的变化。2013年至2016年，犹他州有80例与妊娠相关的死亡（2013-2014年：n=40; 2015-2016年：n=40），其中41例（51%）与妊娠相关（2013-2014年：n=15，2015-2016年：n=26）。在2013-2014年（实施前），12名妇女死于与毒品有关的死亡或自杀，其中只有两人被认为与怀孕有关（17%）。在2015-2016年（实施后），18名妇女死于药物相关死亡或自杀，其中94%（n=17/18）的死亡符合清单上的一项或多项妊娠相关标准（P<.001）。从2013年到2014年再到2015-2016年，犹他州的总体妊娠相关死亡率翻了一番多，从10万分之11.8上升到10万分之25.7（P= 0.08）。在应用标准化标准后，犹他州围产期死亡率审查委员会确定，妊娠本身是导致大多数妊娠和产后妇女意外药物相关死亡或自杀的诱因。其他孕产妇死亡率审查委员会可考虑采用标准化方法评估围产期自杀和与药物有关的意外死亡。
To estimate the proportion of accidental drug-related deaths and suicides classified as pregnancy-related from 2013 to 2014 (preimplementation of standardized criteria) and 2015 to 2016 (postimplementation). Based on Centers for Disease Control and Prevention pregnancy-related death criteria, the Utah Perinatal Mortality Review Committee developed a standardized evaluation tool to assess accidental drug-related death and suicide beginning in 2015. We performed a retrospective case review of all pregnancy-associated deaths (those occurring during pregnancy or 1 year postpartum for any reason) and pregnancy-related deaths (those directly attributable to the pregnancy or postpartum events) evaluated by Utah’s Perinatal Mortality Review Committee from 2013 to 2016. We compared the proportion of accidental drug-related deaths and suicides meeting pregnancy-related criteria preimplementation and postimplementation of a standardized criteria checklist tool using Fisher’s exact test. We assessed the change in pregnancy-related mortality ratio in Utah from 2013 to 2014 and 2015 to 2016 using test of trend. From 2013 to 2016, there were 80 pregnancy-associated deaths in Utah (2013–2014: n=40; 2015–2016: n=40), and 41 (51%) were pregnancy-related (2013–2014: n=15, 2015–2016: n=26). In 2013–2014 (preimplementation), 12 women died of drug-related deaths or suicides, and only two of these deaths were deemed pregnancy-related (17%). In 2015–2016 (postimplementation), 18 women died of drug-related deaths or suicide, and 94% (n=17/18) of these deaths met one or more of the pregnancy-related criteria on the checklist (P<.001). From 2013 to 2014 to 2015–2016, Utah’s overall pregnancy-related mortality ratio more than doubled, from 11.8 of 100,000 to 25.7 of 100,000 (P=.08). After application of standardized criteria, the Utah Perinatal Mortality Review Committee determined that pregnancy itself was the inciting event leading to the majority of accidental drug-related deaths or suicides among pregnant and postpartum women. Other maternal mortality review committees may consider a standardized approach to assessing perinatal suicides and accidental drug-related deaths.