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Mental Health and Maternal Mortality—When New Life Doesn't Bring Joy

      Abstract

      Objective

      To characterize the incidence and risk factors associated with maternal suicide during the peripartum period in an Alberta population. Our secondary objective was to characterize the incidence and risk factors associated with traumatic death in this same population.

      Methods

      This is a retrospective cohort study compared all-cause mortality with death by trauma (suicide, homicide, MVA, drug toxicity) using data collected by the Alberta Perinatal Health Program from 1998 to 2015. Data were summarized using descriptive statistics. The maternal mortality rate was calculated, and χ2 tests were used to determine between group differences with the statistical significance set at P < 0.05.

      Results

      There were 206 perinatal maternal deaths in Alberta from 1998 to 2015; 68 (33%) were due to trauma, 17 (8%) were the result of suicide, 4 (2%) were the result of homicide, and 24 (12%) were related to drug toxicity. The pregnancy-related maternal mortality rate for suicide up to 365 days after birth was 2.05 deaths per 100 000 deliveries. Of these, 29.4% occurred during pregnancy and 70.6%, in the first year postpartum. For homicides, 62.5% of occurred in pregnancy and 37.5% occurred in the first year postpartum.

      Conclusion

      Close to 1 in 5 maternal deaths in Alberta is related to suicide or drug toxicity. We must escalate strategies to prevent deaths from suicide and drug toxicity, as well as increase funding for mental health and addictions screening and treatment.

      Résumé

      Objectifs

      Caractériser la fréquence et les facteurs de risque associés au suicide maternel en période péripartum dans une population de l'Alberta. Notre objectif secondaire était de caractériser la fréquence et les facteurs de risque associés à la mort traumatique dans cette même population.

      Méthodologie

      Il s'agit d'une étude de cohorte rétrospective comparant la mortalité toutes causes confondues avec la mort traumatique (suicide, homicide, accident de véhicule, toxicité médicamenteuse) à partir de données recueillies par le programme de santé périnatale de l'Alberta (Alberta Perinatal Health Program) de 1998 à 2015. Les données ont été résumées à l'aide de statistiques descriptives. Le taux de mortalité maternelle a été calculé et les tests du Chi2 ont été utilisés pour déterminer les différences entre les groupes avec la signification statistique définie à P < 0,05.

      Résultats

      Il y a eu 206 morts maternelles périnatales en Alberta de 1998 à 2015. De ce nombre, 68 (33 %) étaient attribuables à un traumatisme; 17 (8 %), au suicide; 4 (2 %), à un homicide; et 24 (12 %), à une toxicité médicamenteuse. Le taux de mortalité maternelle liée à la grossesse pour le suicide dans les 365 jours après la naissance était de 2,05 morts pour 100 000 accouchements. De ce nombre, 29,4 % se sont produits pendant la grossesse et 70,6 %, dans la première année post-partum. Pour ce qui est des homicides, 62,5 % se sont produits pendant la grossesse et 37,5 %, dans la première année post-partum.

      Conclusion

      Près de 1 mort maternelle sur 5 en Alberta est liée au suicide ou à la toxicité médicamenteuse. Nous devons intensifier nos stratégies pour prévenir les morts par suicide et par toxicité médicamenteuse et augmenter le financement pour le dépistage et le traitement en matière de santé mentale et de toxicomanie.

      Keywords

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