Risk Factors for Pregnancy-Associated Homicide

 

"For every 100,000 live births in the United States during 1991 through 1999, at least 2 women died as a result of homicide during pregnancy or within 1 year after pregnancy," state the authors of an article published in the March 2005 issue of the American Journal of Public Health.

 

In 1999 homicide was the third leading cause of injury-related death among all women (pregnant and nonpregnant) ages 15 through 44 and the second leading cause among women ages 15 through 24 and among black women ages 15 through 44. According to the authors, studies have not been conducted at the national or regional level that focus on the identification of risk factors for and groups at high risk of homicide during pregnancy or in the postpartum period. This report describes homicide deaths occurring within 1 year of pregnancy in the United States from 1991 through 1999.

 

The authors used the Pregnancy Mortality Surveillance System (PMSS), a national, population-based data set, to identify characteristics and risk factors associated with these deaths. A pregnancy-associated death is defined as one occurring during or within 1 year of pregnancy.

 

The authors found that

 

* Of all the pregnancy-associated injury-related deaths reported to PMSS during the study period, 617 (31%) were the result of homicide.

 

* The overall pregnancy-associated homicide ratio for black women (6.4) was about seven times higher than that for white women (0.9).

 

* Women ages 19 and under of all races combined had the highest pregnancy-associated homicide ratio, and the ratio decreased as the woman's age increased.

 

* For both white and black women, those who started prenatal care in the first trimester had the lowest pregnancy-associated homicide ratios.

 

* Firearms were the leading mechanism of pregnancy-associated homicide.

 

The authors conclude that "homicide is the second leading cause of injury-related deaths among pregnant and postpartum women."

 

Chang J, Berg CJ, Saltzman LE, et al. 2005. Homicide: A leading cause of injury deaths among pregnant and postpartum women in the United States, 1991-1999. American Journal of Public Health 95(3):471-477. Abstract available at http://www.ajph.org/cgi/content/abstract/95/3/471.