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- Title
Consensus pregnancy-related criteria for suicide and unintentional overdoses using a Delphi process.
- Authors
Smid, Marcela C.; Vaughn, Porcia; Nowicki, Christine Cooper; Goodman, David A.; Zaharatos, Julie; Campbell, Kristine A.
- Abstract
Suicide and unintentional overdose are leading manners of preventable death during and within a year of pregnancy. Recently, the Utah Maternal Mortality Review Committee (MMRC) developed 10 criteria to guide pregnancy-related classification of these deaths. Our objective was to (1) evaluate if consensus could be reached across experts in maternal mortality review when applying criteria to the determination of pregnancy-relatedness in mock MMRC case evaluation and (2) assess how additional case information shifted participants' determination of pregnancy-relatedness in these mock cases. We used a modified Delphi process to evaluate criteria for pregnancy-related suicides and unintentional overdose. The study team developed base case scenarios to reflect the 10 proposed criteria. Base scenarios varied in timing of death (prenatal or delivery, early postpartum (<6 months), late postpartum (6–12 months)) and level of additional information available (e.g., informant interviews, social media posts). Consensus in favor of a criterion was met when ≥75% of participants identified a case as pregnancy-related in at least 1 scenario. Fifty-eight participants, representing 48 MMRCs, reviewed scenarios. Of 10 proposed criteria, 8 reached consensus. Overall, participants classified 19.4% of base case scenarios as pregnancy-related, which increased to 56.8% with additional information. Pregnancy-related classification changed across timing of death and with availability of additional information (prenatal or delivery 27.7% versus 84.6%; early postpartum 30.0% versus 58.3%; late postpartum 0.0% versus 25.0%, respectively). We identified consensus supporting the application of 8 standardized criteria in MMRC determinations of pregnancy-relatedness among suicide and unintentional overdose deaths.
- Subjects
CONSENSUS (Social sciences); SUICIDE; DRUG overdose; INTERVIEWING; PUERPERIUM; DESCRIPTIVE statistics; MATERNAL mortality; DELPHI method; PERINATAL period
- Publication
Archives of Women's Mental Health, 2024, Vol 27, Issue 1, p109
- ISSN
1434-1816
- Publication type
Article
- DOI
10.1007/s00737-023-01375-4