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The European Journal of Public Health Advance Access published online on July 28, 2005
The European Journal of Public Health, doi:10.1093/eurpub/cki042
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© The Author 2005. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.
Received November 19, 2003
Accepted July 22, 2004

Article

Injury deaths, suicides and homicides associated with pregnancy, Finland 1987-2000

Mika Gissler 1*, Cynthia Berg 2, Marie-Hélène Bouvier-Colle 3, and Pierre Buekens 4

1 STAKES National Research and Development Centre for Welfare and Health, STAKES Information Division, Helsinki, Finland
2 CDC Centers for Disease Control and Prevention, Division of Reproductive Health, Atlanta, Georgia, USA
3 INSERM Institut National de la Santé et de la Recherche Médicale - U 149 Epidemiological Research Unit on Perinatal and Women Health, Paris, France
4 School of Public Health and Tropical Medicine, Tulane University, New Orleans, USA

* To whom correspondence should be addressed.
Mika Gissler, E-mail: mika.gissler{at}stakes.fi


  Abstract

Background: Only few studies have been carried out on the relationship between pregnancy and deaths from external causes. Methods: Information on deaths from external causes among women aged 15-49 years in Finland in 1987-2000 (n = 5299) was linked to three national health registers to identify pregnancy-associated deaths (n = 212). Results: The mortality rate for women during pregnancy and within 1 year of pregnancy termination from external causes was lower than mortality from external causes among non-pregnant women (relative risk 0.79; 95% confidence interval 0.69-0.91). Owing to elevated suicide and homicide rates, however, an increased risk was observed for women after abortions, especially in the age group of 15-24 years. Conclusions: The low rate of deaths from external causes suggests the protective effect of childbirth, but the elevated risk after a terminated pregnancy needs to be recognized in the provision of health care and social services.

Keywords: birth; external cause of death; induced abortion; register linkage study; spontaneous abortion.
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