OBJECTIVE: 

To analyze differences in the demographic and social factors associated with pregnancy-associated violent deaths due to homicide compared with suicide by pregnancy timing.

METHODS: 

This was a retrospective cohort study using the Centers for Disease Control and Prevention's National Violent Death Reporting System from 2008 to 2019. We included females aged 15–44 years who died by suicide, defined as intentional self-harm, or homicide. Pregnancy-associated deaths were defined as those that occurred during or within 1 year of pregnancy.

RESULTS: 

Of 38,417 female victims aged 15–44 years identified in the data set, 10,411 had known pregnancy status; 1,300 of those deaths were pregnancy associated. Of all deaths with known pregnancy status, 3,203 were by homicide (30.8%) and 7,208 (69.2%) were by suicide. Pregnancy-associated homicide deaths made up 20.6% of all homicide deaths, and pregnancy-associated suicide deaths made up 8.8% of all suicide deaths. Individuals who died by homicide were younger (29.4±8.2 years vs 31.5±8.6 years), more likely to be single or never married (61.0% vs 50.0%), and had a higher proportion of associate’s degree–level education or less as compared with individuals who died by suicide (28.1% vs 43.9%). Of individuals who died by homicide, 37.7% were Black or African American, 13.4% were Hispanic, and 56.0%% were White. In comparison, 6.9% of individuals who died by suicide were Black or African American, 8.0% were Hispanic, and 85.0% were White. Having a mental health problem and any substance use were significantly more often associated with suicide deaths compared with homicide deaths (77.4% vs 7.2%, P<.001 for mental health, 33.3% vs 12.8%, P<.001 for substance use, respectively). Intimate partner violence was prevalent in both groups, although significantly higher in homicide deaths (57.3% vs 37.1%, P<.001). This pattern persisted when stratified by pregnancy status.

CONCLUSION: 

Mental health problems, substance use disorder, and intimate partner violence are preceding circumstances to pregnancy-associated suicide and homicide.

中文翻译：

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妊娠相关杀人和自杀：2008-2019 年国家暴力死亡报告系统分析

客观的： 

通过怀孕时间分析与因凶杀和自杀导致的妊娠相关暴力死亡相关的人口统计学和社会因素的差异。

方法： 

这是一项回顾性队列研究，使用疾病控制和预防中心的 2008 年至 2019 年全国暴力死亡报告系统。我们纳入了 15-44 岁死于自杀（定义为故意自残或他杀）的女性。妊娠相关死亡定义为妊娠期间或妊娠 1 年内发生的死亡。

结果： 

在数据集中确定的 38,417 名年龄在 15-44 岁之间的女性受害者中，有 10,411 名已知怀孕状况；其中 1,300 例死亡与怀孕有关。在已知怀孕状态的所有死亡中，3,203 人死于他杀 (30.8%)，7,208 人 (69.2%) 死于自杀。与妊娠相关的他杀死亡占所有他杀死亡的 20.6%，与妊娠相关的自杀死亡占所有自杀死亡的 8.8%。死于他杀的人更年轻（29.4±8.2 岁 vs 31.5±8.6 岁），单身或从未结过婚的可能性更大（61.0% vs 50.0%），受过或低于副学士学位教育的比例更高与死于自杀的人（28.1% 对 43.9%）。在死于他杀的个人中，37.7% 是黑人或非裔美国人，13.4% 是西班牙裔，56.0% 是白人。相比之下，6。9% 死于自杀的人是黑人或非裔美国人，8.0% 是西班牙裔，85.0% 是白人。与他杀死亡相比，有精神健康问题和任何物质使用与自杀死亡的相关性明显更高（77.4% 对 7.2%，心理健康P <.001，分别为33.3% 和 12.8%，物质使用P <.001）。亲密伴侣暴力在这两个群体中都很普遍，尽管凶杀死亡人数明显更高（57.3% 对 37.1%，P <.001）。当按妊娠状态分层时，这种模式仍然存在。

结论： 

心理健康问题、物质使用障碍和亲密伴侣暴力是导致妊娠相关自杀和杀人的先决条件。