Few pregnant people who died of overdose, suicide in Michigan received proper treatment before death

Jan. 6, 2023
A review of maternal deaths suggests most individuals had documented behavioral health conditions but only one-third received appropriate pharmacologic treatment before death.

Most pregnant individuals who died of suicide or overdose in one state sample had diagnoses of mental health or substance use conditions – but few received proper therapy before death – a study suggests.

Michigan Medicine researchers analyzed 237 maternal deaths due to suicide or overdose occurring between 2008 and 2018 in Michigan, finding that more than two thirds of cases involved a documented behavioral health condition.

However, only a third of these patients were receiving psychotropic medications, such as antidepressants, anti-anxiety medicine or mood stabilizers prior to their death.

Similarly, of those who died of substance overdose, more than two thirds of individuals had a documented substance use condition. Less than a third of these patients were being treated with medication assisted therapy, such as suboxone, which helps fight opioid addiction.

Most deaths occurred within three months postpartum but more than half of all deaths occurred between 4 to 12 months postpartum, according to the findings in the American Journal of Obstetrics and Gynecology – Maternal Fetal Medicine.

Prescription opioids were the most common substance found on postmortem toxicology reports, and among these patients, nearly half had a physician-prescribed opioid. Of those with substance overdose deaths, 42.9% had an opioid prescription, 44.3% had a benzodiazepine prescription, and 32.5% had a prescription for both.

The retrospective study involved a secondary review of deceased patients’ records over a decade at the Michigan Department of Health and Human Services through the Michigan Maternal Mortality Surveillance Program. Researchers reviewed pregnancy-related and pregnancy-associated deaths.

Recent reports indicate that maternal deaths related to suicide and overdose are increasing and may be the leading contributors to maternal mortality up to one year postpartum.

U of M Health release