The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #66219

Dilys Walker, MD¹, Bernardo Hernandez, PhD², Lourdes Campero, MEd¹, Ana Langer, MD³, and Henry Espinoza, MD MPH⁴. (1) Centro de Investigación de Salud Poblacional, Instituto Nacional de Salud Publica, Avenida Universidad 655, Cuernavaca, Mexico, 52 777 311 3783, dwalker@correo.insp.mx, (2) Centro de Investigación en Salud Poblacional, CentrInstituto Nacional de Salud Pública Avenida Universidad No. 655, Cuernavaca Mexic, Avenida Universidad No. 655, Cuernavaca Mexic, Cuernavaca, Mexico, (3) Population Council, Avenida Escondida, Mexico City, Mexico, (4) Regional office for Latin America, Population Council, Escondida 110, Col. Villa Coyoacan, Mexico City, Mexico

Background: In general, violent deaths in pregnant or post partum women are not registered as maternal deaths. There is little data evaluating the contribution of violence to overall maternal mortality and morbidity. Objective: To evaluate verbal autopsy as a means to identify and measure the association between violence with maternal mortality in the State of Morelos, Mexico. Materials and Methods: All 394 death certificates of reproductive aged women (12-50) who died in Morelos in 2001 were reviewed. Using a lits of suspicious diagnosis, we selected 223 cases for further review, including all violent deaths (51). Verbal autopsy was conducted in each of these cases. Results: We identified 23 maternal deaths. Of these, 18 were officially registered as maternal deaths. In addition, 2 adolescent suicides, 1 adult suicide, and one homicide were identified in pregnant or post partum women. The adolescent suicides may have been abortion attempts. Another 3 violent deaths were identified in women up to 6 months post partum. In 6 (23%)of the 23 non violent maternal deaths, the women were living with ongoing physical violence. Looking only at the 51 violent deaths, 4 (8%) occurred in women who were pregnant or recently post partum at the time of death. Conclusions: Our data suggest that violence is an important contributor to overall maternal mortality and morbidity. Studies evaluating causes of maternal mortality and morbidity should consider the role of violence.

Learning Objectives:

• 1. Recognize the relationship between violence and maternal mortality.
• 2. Evaluate the role and value of verbal autopsy in identifying violent deaths that occurred in pregnant and post partum women.
• 3. Recognize the association between suicide and pregnancy in Mexican adolescents

Keywords: Violence, Maternal Morbidity

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.