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To the Editor: In their article about pregnancy-associated mortality, Drs Horon and Cheng¹ emphasized the need to move beyond traditional definitions of maternal mortality. It is also important to move beyond the perception that homicide is the only major contributor to pregnancy-associated injury mortality. Although Horon and Cheng indicated that some pregnancies in their study were undetected, they did not address the limitation of the sample's representativeness. Another issue is the difficulty detecting all pregnancies in motor vehicle traffic (MVT) deaths.

The policy of the Maryland medical examiner's office is to perform an autopsy for all cases of homicide. For MVT-related deaths, the usual policy is to perform an autopsy on drivers who die after a brief hospitalization, but passengers are generally not examined unless they are the only fatality (John Smialek, MD, chief medical examiner, state of Maryland, oral communication, March 23, 2001). The Federal Fatal Accident Reporting System . . . [Full Text of this Article]

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