Dannenberg A L, Carter D M, Lawson H W, Ashton D M, Dorfman S F, Graham E H
Injury Prevention Center, Johns Hopkins University School of Hygiene and Public Health, Baltimore, MD, USA.
Am J Obstet Gynecol. 1995 May;172(5):1557-64. doi: 10.1016/0002-9378(95)90496-4.
We attempted to document the role of homicide and other injuries as causes of maternal death and to compare the risk of fatal injury among pregnant women with that in the general population.
We reviewed New York City medical examiner records of 2331 women aged 15 to 44 years who died of injury in 1987 through 1991. Pregnancies were identified from autopsy information.
A total of 115 (39%) of 293 deaths in currently or recently pregnant women were attributable to injury. These 115 deaths included homicide (63%), suicide (13%), motor vehicle crashes (12%), and drug overdoses (7%). Minority women were overrepresented among the injury deaths (black 53%, Hispanic 24%, white 19%). Recent substance use was documented in 48% of the injury deaths. Pregnancy was documented on only 35% of the 115 death certificates. The risk of fatal injury is similar for currently pregnant women and for women in the general population, except for an increased risk of homicide among pregnant black women.
Homicide and other injuries are major contributors to maternal mortality and should be (but rarely are) included routinely in maternal mortality surveillance systems. Prenatal and postpartum clinic visits represent an ideal time to implement interventions to prevent injuries among pregnant women.
我们试图记录他杀及其他伤害作为孕产妇死亡原因的作用，并比较孕妇与普通人群中致命伤害的风险。
我们回顾了纽约市法医记录的1987年至1991年间死亡的2331名15至44岁女性的资料。通过尸检信息确定其是否怀孕。
在当前或近期怀孕的女性的293例死亡中，共有115例（39%）归因于伤害。这115例死亡包括他杀（63%）、自杀（13%）、机动车碰撞事故（12%）和药物过量（7%）。少数族裔女性在伤害死亡中占比过高（黑人占53%，西班牙裔占24%，白人占19%）。48%的伤害死亡记录有近期药物使用情况。在115份死亡证明中，仅有35%记录有怀孕情况。除了怀孕黑人女性他杀风险增加外，当前怀孕女性与普通人群中致命伤害的风险相似。
他杀及其他伤害是孕产妇死亡的主要原因，应（但很少）常规纳入孕产妇死亡监测系统。产前和产后门诊就诊是实施干预措施以预防孕妇伤害的理想时机。
