Self-harm is the leading cause of death in new mothers in Colorado, CU research study finds

AURORA, Colo. – Self-harm was the leading cause of pregnancy-associated deaths in Colorado from 2004 to 2012, a University of Colorado Anschutz Medical Campus study has found.

The findings, published in the December edition of Obstetrics & Gynecology, found these deaths to be ahead of crashes, medical conditions and homicide.

The study found that of 211 maternal deaths, 30 percent were from self-harm, defined by CU researchers as suicide and nonintentional overdose deaths during pregnancy and the first year after giving birth.

During the study time frame, 63 women died of suicide or a drug overdose, researchers found. Of those, 26 died of suicide by hanging, the most common cause of death.

In overdose deaths in which toxicology tests were done during autopsies, opioids were the most detected drug used, "chiefly pharmaceutical painkillers" but also heroin, researchers found.

Even though about half the self-harm cases were found to be taking prescription drugs for mental health care at conception, 48 percent stopped using the medications during pregnancy, in some cases with a care provider’s recommendation but in most without, according to researchers.

Substance abuse and psychiatric disorders -- most often depression -- were found in a majority of the women with maternal deaths. But, researchers found, no risk factor was found in 22 percent of the cases.

“This finding speaks to the importance of an informed discussion of the risks and benefits of continuing psychiatric medications during pregnancy,” said lead author, Dr. Torri Metz. “Ideally this would occur prior to conception. The benefit of continuing medications, especially SSRIs in women with depression, frequently strongly outweighs the risk.”

In Colorado alone, deaths from self-harm during those eight years was 9.6 per 100,000 live births. About 90 percent occurred in the postpartum period, researchers found.

Researchers also found that many of the women in the study had documented social stressors, such as unemployment (64 percent), or were either single, divorced or separated (40 percent). The study found only a third of the women tried connecting with a social worker either during prenatal care or at delivery.

It is not known how the demographics and characteristics of maternal deaths in Colorado compare to other states or if such self-harm deaths are becoming more common, according to Nathan Gill CU Anschutz Medical Campus spokesman.

In 2012, suicide was overall the most common cause of death in Colorado among those aged 10 to 44.