
@article{ref1,
title="Maternal deaths using coroner's data: a latent class analysis",
journal="Journal of obstetrics and gynaecology Canada",
year="2024",
author="Aflaki, Kayvan and Vigod, Simone N. and Sprague, Ann E. and Cook, Jocelynn and Berger, Howard and Aoyama, Kazuyoshi and Jhirad, Reuven and Ray, Joel G.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="OBJECTIVE: Knowledge regarding the antecedent clinical and social factors associated with maternal death around the time of pregnancy is limited. This study identified distinct subgroups of maternal deaths using population-based coroner's data, and that may inform ongoing preventative initiatives. <br><br>METHODS: A detailed review of coroner's death files was performed for all of Ontario, Canada, where there is a single reporting mechanism for maternal deaths. Deaths in pregnancy, or within 365 days thereafter, were identified within the Office of the Chief Coroner for Ontario database, 2004-2020. Variables related to the social and clinical circumstances surrounding the deaths were abstracted in a standardized manner from each death file, including demographics, forensic information, nature and cause of death, and antecedent health and healthcare factors. These variables were then entered into a latent class analysis (LCA) to identify distinct types of deaths. <br><br>RESULTS: Among 273 deaths identified in the study period, LCA optimally identified three distinct subgroups, namely, (1) in-hospital deaths arising during birth or soon thereafter (52.7% of the sample); (2) accidents and unforeseen obstetric complications also resulting in infant demise (26.3%); and (3) out-of-hospital suicides occurring postpartum (21.0%). Physical injury (22.0%) was the leading cause of death, followed by hemorrhage (16.8%) and overdose (13.3%). <br><br>CONCLUSION: Peri-pregnancy maternal deaths can be classified into three distinct sub-types, with somewhat differing causes. These findings may enhance clinical and policy development aimed at reducing pregnancy mortality.<p /> <p>Language: en</p>",
language="en",
issn="1701-2163",
doi="10.1016/j.jogc.2024.102349",
url="http://dx.doi.org/10.1016/j.jogc.2024.102349"
}