EAST LANSING, Mich. (WLNS) – A Michigan State University study shows that the pandemic was just the tip of the iceberg for causes of death in pregnant and postpartum people.

According to a new MSU study published in JAMA Network Open, the overall pregnancy-associated death ratio in 2020 was 66.9 deaths per 100,000 live births, an increase of 35% from the previous year.

“We suspect these deaths are just the tip of the iceberg in terms of morbidity and suffering due to mental health, intimate partner violence and substance use during pregnancy and postpartum,” said MSU Professor of Epidemiology and Biostatistics Claire Margerison.

Magerison added that they are looking to get a better understanding of the pandemic’s impact on pregnant people.