Substance Use Disorder-Related Deaths and Maternal Mortality in New Mexico, 2015-2019

BackgroundIn recent decades, maternal mortality has increased across the U.S. Experiences of pregnant and postpartum people with Substance Use Disorder (SUD)-related deaths have not been previously evaluated in New Mexico. The aim of this study was to analyze risk factors related to substance use and explore substance use patterns among pregnancy-associated deaths in New Mexico from 2015 to 2019.MethodsWe conducted an analysis of pregnancy-associated deaths to assess the association between demographics, pregnancy factors, circumstances surrounding death, treatment of mental health conditions, and experiences with social stressors among Substance Use Disorder (SUD)-related and non-SUD-related deaths. We performed univariate analyses of risk factors using chi-square tests to assess the differences between SUD-related and non-SUD-related deaths. We also examined substance use at time of death.ResultsPeople with SUD-related deaths were more likely to die 43-365 days postpartum (81% vs. 45%, p-value = 0.002), have had a primary cause of death of mental health conditions (47% vs 10%, p < 0.001), have died of an overdose (41% vs. 8%, p-value = 0.002), have had experienced any social stressors (86% vs 30%, p < 0.001) compared to people with non-SUD-related deaths, and received treatment for SUD at any point before, during, or after pregnancy (49% vs. 2%, p < 0.001). The substances most used at time of death were amphetamines (70%), and most cases engaged in polysubstance use (63%).Conclusions for PracticeProviders, health departments, and community organizations must prioritize supporting people using substances during and after pregnancy to prevent death and improve quality of life for pregnant and postpartum people. SignificanceWhat is Already Known on this Subject? Maternal mortality rates have been increasing across the U.S. Substance use and overdoses are leading causes of death among pregnant and postpartum people. Return to use in the postpartum period following abstinence during pregnancy is common. New Mexico has some of the highest rates of death attributed to alcohol use, and experiences high rates of substance use.What does this study add? This study provides background on risk factors for Substance Use Disorder (SUD)-related death among pregnant and postpartum people in New Mexico. It explores experiences with mental health treatments and social stressors, and substance use patterns among pregnant and postpartum people with SUD-related deaths.