Evidence map›Paper›PMID 38172275›Full record

ArticleArchives of women's mental health2024

Perinatal mental health and pregnancy-associated mortality: opportunities for change.

Joan L Combellick, Aryan Esmaeili, Amanda M Johnson, Sally G Haskell, Ciaran S Phibbs, Laura Manzo, Laura J Miller

Abstract read
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In one paragraph

Article in Archives of women's mental health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Early pregnancy depressive symptoms and severe maternal morbidity.American journal of obstetrics & gynecology MFM · 2026
    Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Joan L CombellickDepartment of Veterans Affairs, Veterans Health Administration, Office of Women's Health, 810 Vermont Ave NW, Washington, DC, 20420, USA. Joan.combellick@va.gov.ORCID 0000-0003-3163-9467
Aryan EsmaeiliHealth Economics Resource Center (HERC), Palo Alto VA Medical Center, 795 Willow Road, Menlo Park, Palo Alto, CA, 94025, USA.
Amanda M JohnsonDepartment of Veterans Affairs, Veterans Health Administration, Office of Women's Health, 810 Vermont Ave NW, Washington, DC, 20420, USA.
Sally G HaskellDepartment of Veterans Affairs, Veterans Health Administration, Office of Women's Health, 810 Vermont Ave NW, Washington, DC, 20420, USA.
Ciaran S PhibbsHealth Economics Resource Center (HERC), Palo Alto VA Medical Center, 795 Willow Road, Menlo Park, Palo Alto, CA, 94025, USA.
Laura ManzoSchool of Nursing, Yale University, 400 West Campus Drive, Orange, CT, 06477, USA.
Laura J MillerDepartment of Veterans Affairs, Veterans Health Administration, Women's Mental Health, Office of Mental Health and Suicide Prevention, 810 Vermont Ave NW, Washington, DC, 20420, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Perinatal mental health conditions have been associated with adverse pregnancy outcomes, including maternal death. This quality improvement project analyzed pregnancy-associated death among veterans with mental health conditions in order to identify opportunities to improve healthcare and reduce maternal deaths. Pregnancy-associated deaths among veterans using Veterans Health Administration (VHA) maternity care benefits between fiscal year 2011 and 2020 were identified from national VHA databases. Deaths among individuals with active mental health conditions underwent individual chart review using a standardized abstraction template adapted from the Centers for Disease Control and Prevention (CDC). Thirty-two pregnancy-associated deaths were identified among 39,720 paid deliveries with 81% (n = 26) occurring among individuals with an active perinatal mental health condition. In the perinatal mental health cohort, most deaths (n = 16, 62%) occurred in the late postpartum period and 42% (n = 11) were due to suicide, homicide, or overdose. Opportunities to improve care included addressing (1) racial disparities, (2) mental health effects of perinatal loss, (3) late postpartum vulnerability, (4) lack of psychotropic medication continuity, (5) mental health conditions in intimate partners, (6) child custody loss, (7) lack of patient education or stigmatizing patient education, and (8) missed opportunities for addressing reproductive health concerns in mental health contexts. Pregnancy-associated deaths related to active perinatal mental health conditions can be reduced. Mental healthcare clinicians, clinical teams, and healthcare systems have opportunities to improve care for individuals with perinatal mental health conditions.

Indexed as

Mental DisordersPregnancy ComplicationsUnited States Department of Veterans AffairsAdultFemaleHumansMaternal MortalityMental HealthPostpartum PeriodPregnancyPregnancy OutcomeQuality ImprovementUnited StatesVeteransMaternal outcomesMaternity carePerinatal mental healthPregnancy-associated mortalityVeterans

Identifiers

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.