299: Florida's pregnancy-associated deaths (PADs) due to substance use 2005-2016


      Substance use overdoses are a leading cause of death among women and are now considered an epidemic within the United States. According to the Centers for Disease Control and Prevention, the rate for drug overdose deaths has increased approximately 140% between 2000 and 2014, driven largely by opioid overdose deaths. A pregnancy-associated death (PAD) such as from substance use is a death of a woman from any cause, while she is pregnant or within one year of termination of pregnancy, regardless of the duration and site of the pregnancy. PADs are categorized as pregnancy related or not. The objective was to examine PADs due to substance use.

      Study Design

      The PAMR committee reviewed 2434 PADs from 2005 to 2016. Deaths and their circumstances, the direct result of substance use overdoses were examined. Data sources were underlying cause of death on death certificates and number of live births on birth certificates. The overall pregnancy associated mortality ratio and that due to substance use were measured. Participants were pregnant and postpartum within one year.


      Findings indicate substance misuse is a significant contributing factor of all pregnancy-associated deaths in Florida regardless of the actual cause or manner of death. Slightly more than 12% (300) of the 2005-2016 deaths reviewed were the direct result of substance use overdoses, mostly from accidents or suicides. In 2016, there were 41 cases or 25.7% deaths from substance use. The PAMR committee found (Figure 1) the pregnancy associated mortality ratio increased 11.0% from 2005 to 2016. The pregnancy associated mortality ratio due to substance use increased 6-fold from 2005 to 2016. PADs with substance use as the primary cause of death increased 645% from 2005 to 2016. PADs with substance use as associated cause of death increased 144% from 2005 to 2016 (Figure 2).