Consensus pregnancy-related criteria for suicide and unintentional overdoses using a Delphi process

Details

• Alternative Title:
  Arch Womens Ment Health
• Personal Author:
  Smid, Marcela C. ; Vaughn, Porcia ; Nowicki, Christine Cooper ; Goodman, David A. ; Zaharatos, Julie ; Campbell, Kristine A.
• Description:
  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 Drug Overdose Female Humans Maternal Mortality Postpartum Period Pregnancy Suicide
• Keywords:
  Delphi Method Drug Overdose Maternal Mortality
• Source:
  Arch Womens Ment Health. 27(1):109-125
• Pubmed ID:
  37770631
• Pubmed Central ID:
  PMC11000257
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/ ; NU38OT000288/OT/OSTLTS CDC HHSUnited States/ ; UL1 RR025764/RR/NCRR NIH HHSUnited States/ ; 8UL1RR000105/TR/NCATS NIH HHSUnited States/
• Volume:
  27
• Issue:
  1
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:3b5da6dba5098f55ff31eb8b69e00496d80b8f1a173e3c66ff00bb3da950fadc
• Download URL:
  https://stacks.cdc.gov/view/cdc/154125/cdc_154125_DS1.pdf
• File Type:
  [PDF - 1.46 MB ]