Abstract
Substance use disorder (SUD) is increasingly linked with risk of accidental overdose and suicide among pregnant and postpartum people. However, less is understood about SUD as a contributing factor to natural manner of death among peripartum people. This study used National Vital Statistics System data to investigate differences in causes and timing of natural deaths between peripartum women and girls with and without SUD as a contributing factor to their deaths. Compared with deaths in individuals without SUD as a contributing factor, deaths in individuals with SUD as a contributing factor were less likely to occur postpartum and were more likely to be due to sepsis. These patterns have not been identified previously in the literature. Further investigation is needed to clarify the mechanisms behind SUD and causes of pregnancy-associated natural deaths.