Drug and Alcohol Poisoning-Related Deaths Are Rising in the Pregnant Population

Pregnancy is filled with lists of do’s and don’ts to keep parents and babies safe. Individuals who are expecting are told to take precautions to stay healthy, from following the doctor’s orders to helpful advice in online forums.

Despite the availability of medical care and education on important prenatal regimens, deaths during pregnancy or after childbirth are still a problem in the United States. Per every 100,000 live births in the U.S. in 2018, there were more than 17 maternal deaths—more than double the deaths of most other wealthy countries. While past research often focused on deaths caused by pregnancy-related issues, a new study looked into other rising causes of maternal mortality.

“We found that all-cause mortality among pregnant and recently pregnant women increased from 2015 to 2019 … Deaths from drug and alcohol poisonings increased significantly,” states Jeffrey Howard, PhD, an associate professor in the department of public health at the University of Texas at San Antonio. Dr. Howard, the lead author of the study, notes that deaths from homicide also increased.

In addition to giving more information about the risks and causes of maternal mortality, the study, published in the Journal of the American Medical Association, also highlights the need for better care for expectant parents. Let's take a closer look at maternal mortality and what can be done to reduce it.

What is Maternal Mortality?

Maternal death occurs when a person dies while pregnant, during labor and delivery, or within 42 days of giving birth or ending the pregnancy. The Centers for Disease Control and Prevention (CDC) states that about 700 women die every year in the United States from problems during pregnancy or delivery.

A 2020 study notes that advanced age, having twins or triplets, race, ethnicity, and socioeconomic status can put a person at higher risk of maternal death. Black and American Indian/Alaska Native women were found to have the highest risk.

While some risk factors are things that a person can’t help, the study calls attention to factors that a pregnant individual can control to improve the odds against maternal death.

All About the Study

Researchers from The University of Texas at San Antonio wanted to learn more about the causes of death among pregnant and recently pregnant individuals. They also wanted to find out whether maternal mortality numbers were increasing. To do this, they combed death records from the National Center for Health Statistics, compiled in the U.S. from 2015-2019.

The focus was on all the causes of death in women who were pregnant through one year after their pregnancy. Because researchers looked at national data, they were able to pull data from a diverse population, examining over 9500 records.

Dr. Howard notes that researchers thought they would see an increase in pregnancy-specific causes of death. Instead, they uncovered surprising trends.

“The increase in drug and alcohol poisoning deaths was quite large. It doubled over the five years of the study, from 4.3 per 100,000 live births in 2015 to 8.8 per 100,000 live births in 2019, an increase of 17.4% each year,” Dr. Howard explains. “That is really a staggering figure, and points to a significant problem in the U.S. regarding drug and alcohol consumption patterns,” he continues.

Mortality rates from homicides also increased, from 2 to 3.9 per 100,000 live births, an increase of 13.5% each year. Though experts note this increase is not considered statistically significant, they say it shines a light on the societal issue of violence towards women.

Main Causes of Maternal Mortality

External factors, such as bias, racism, insufficient access to needed healthcare, and lack of education contribute to maternal deaths. But if a patient is aware of certain internal factors, that awareness can go a long way in keeping them healthy.

“The majority of maternal deaths are preventable. Being aware of common conditions that can increase a patient’s morbidity and mortality can help to reduce a patient’s risk, such as hemorrhage, cesarean delivery, and recognition and treatment of preeclampsia or high blood pressure in pregnancy,” explains Sam Bauer, MD, CPE, FACOG, an associate professor of obstetrics and gynecology and maternal-fetal medicine at Duke University Medical Center. 

As the study notes, drug and alcohol poisoning are also causes of maternal death. Lifestyle choices, including smoking and drinking, contribute to this cause.

Other causes include preexisting conditions like cardiovascular disease, asthma, and having a compromised immune system. High blood sugar during pregnancy, or gestational diabetes, also creates greater risk.

Worldwide Maternal Mortality Rates

In countries with less access to quality healthcare, maternal deaths are startlingly high. Worldwide, every day in 2017, over 800 women died from causes related to pregnancy and delivery. Infection, disease, and poverty compound the problem. While the maternal mortality ratio dropped by 38% between 2000 and 2017, there were still many preventable deaths.

“There’s no acceptable rate of maternal mortality,” states Julie Zaharatos, a member of the Maternal Mortality Prevention Team in CDC’s Division of Reproductive Health.

In the United States, there were 754 women who died from maternal causes in 2019. Better procedures need to be in place to deliver a baby. "Given all of the medical advancements over the last couple of decades and improvements in technology...I still don’t understand exactly why the U.S. maternal mortality rate is as high as it is,” adds Dr. Howard.

Making Pregnancy Safer

The CDC notes that three out of five deaths maternal deaths can be prevented. The organization has developed the Hear Her campaign to provide needed information on pregnancy-related complications.

The campaign notes that recognizing warning signs is key. Headaches that persist or get worse, blurred vision, swelling or loss of feeling in your hands or face, trouble breathing, nausea, and vaginal bleeding are some of the symptoms you should discuss with a healthcare provider.

Also, do all you can to ensure you are in an environment where you feel safe. If you are living in a dangerous or unhealthy situation, seek help. You can call the Domestic Violence hotline, at 1-800-799-SAFE (7233) or chat online at thehotline.org.

Exposing the enormous problem of maternal mortality is key in working towards a solution.

“We hope that by shedding light on this, more research will be conducted to understand the socioeconomic and structural factors related to this problem, [that it] will be better understood, and lead to improved prevention and intervention efforts to reduce mortality,” concludes Dr. Howard.