Deaths during pregnancy and the first year postpartum increased by 35% in the first nine months of the pandemic compared to the prior year, according to a new study.

The research found that deaths due to drugs, homicides, obstetric causes, and motor vehicle accidents all increased by 25%-55% during that period.

Only pregnancy-associated suicides declined during 2019-20, says study lead author Claire Margerison, an associate professor of epidemiology and biostatistics in the Michigan State University College of Human Medicine.

“We suspect these deaths are just the tip of the iceberg in terms of morbidity and suffering due to mental health, intimate partner violence, and substance use during pregnancy and postpartum,” says Margerison, a population health scientist in the epidemiology and biostatistics department. “These causes of death have been increasing over time, but it appears the pandemic exacerbated the ongoing upward trend in these deaths.”

For the study, published in JAMA Network Open, the researchers looked at death certificate records between 2018-20 of female US residents ages 15 to 44. The certificates have a standardized pregnancy box asking whether the decedent was pregnant at the time of death, within 42 days of death, or between 43 days and one year of death. All three categories were included as pregnancy-associated deaths. After calculating the pregnancy-associated death ratio, which previous studies had looked at, the researchers also looked at causes of death.

According to the report, the overall pregnancy-associated death ratio in 2020 was 66.9 deaths per 100,000 live births, an increase of 35% from the previous year. In that period, deaths due to drugs increased 55%; homicides by 41%; obstetric causes by 28%, and other causes (primarily motor vehicle accidents) by nearly 57%.

“Pregnancy is considered a window of opportunity for screening and prevention related to physical, mental, and behavioral health,” Margerison says. “Our data suggest that such opportunities were missed for hundreds of families during the pandemic.

“There is a critical need for prevention and intervention efforts—including harm reduction strategies—tailored to pregnant and postpartum people, particularly during times of population stress and decreased utilization of preventive care, such as a pandemic.”

Read the full article about pregnancy postpartum deaths by Nardy Baeza Bickel at Futurity.