MATERNAL DEATHS DUE TO HOMICIDE AND OTHER INJURIES IN NORTH-CAROLINA - 1992-1994

Objective: To determine the role of homicide and other injuries in mat ernal deaths in North Carolina over the three-year period from 1992 th rough 1994. Methods: Maternal deaths were identified from death certif icates that indicated a maternal death and through an enhanced surveil lance system that matches death certificates with live-birth and fetal -death certificates. Deaths were classified as direct, indirect, medic ally unrelated, or injury related. Patterns of prenatal care were asce rtained from the matching live-birth or fetal-death certificates. Mate rnal death rates for whites and nonwhites were calculated. Results: Th e most common cause of maternal death was injury, accounting for 62 of the 167 deaths (37%). Homicide was the most common cause of injury-re lated death (35.5%). The relative risk of maternal death for nonwhites compared with whites was 1.8 (95% confidence interval [CI] 1.6, 2.1). Similarly, their relative risk for injury-related maternal death was 1.7 (95% CI 1.4, 2.2). Conclusion: It is essential to include an analy sis of injury related deaths in maternal mortality reporting. As the m ost common cause of maternal deaths, injury is not limited to densely populated, metropolitan areas. Counseling regarding injury prevention, domestic violence, and depression should be a part of both prenatal a nd postpartum care. (C) 1997 by The American College of Obstetricians and Gynecologists.