A study of the teratogenic and fetotoxic effects of large doses of amobarbital used for a suicide attempt by 14 pregnant women

Petik, D.; Timmermann, G.; Czeizel, Andr̀ew E.; Ács, Nándor; Bánhidy, Ferenc

doi:10.1177/0748233708093314

Cited by 8 publications

(3 citation statements)

References 12 publications

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“…We did not find a higher rate of mental retardation in exposed children born to mothers who attempted suicide with either amobarbital, 20 glutethimide 21 or promethazine 22 taken separately, compared with the data of their sibs in the previous studies of these drugs. Thus only the combination of the three drugs in Tardyl® produced a high risk for mental retardation and very low IQ.…”

Section: Discussioncontrasting

confidence: 79%

A study of the risk of mental retardation among children of pregnant women who have attempted suicide by means of a drug overdose

et al. 2012

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Abstract:Background:The aim of the study was to estimate the effect on the fetal development of high doses of prescription drugs taken as a suicide attempt during pregnancy.Methods:Pregnant women were identified among self-poisoned females in the toxicological inpatient clinic in Budapest between 1960 and 1993. Congenital abnormalities, intrauterine development based on birth weight and post-conceptional age, mental retardation, cognitive-behavioral status were compared in exposed children born to mothers who had attempted suicide by means of a drug overdose during pregnancy with their siblings, born either before or after the affected pregnancy, as sib controls.Results:Of a total of 1 044 pregnant women, 74 used the combination of amobarbital, glutethimide and promethazine (Tardyl®, one of the most popular drugs for treatment of insomnia in Hungary) for suicide attempt. Of these 74 women, 27 delivered live-born babies. The mean dose of Tardyl® used for suicide attempts was 24 times the usually prescribed clinical dose. The rate of congenital abnormalities and intrauterine retardation was not higher in exposed children than in their sib controls. However, of the 27 exposed children, eight (29.6%) were mentally retarded (Χ\documentclass[12pt]{minimal} \usepackage{wasysym} \usepackage[substack]{amsmath} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage[mathscr]{eucal} \usepackage{mathrsfs} \DeclareFontFamily{T1}{linotext}{} \DeclareFontShape{T1}{linotext}{m}{n} { <-> linotext }{} \DeclareSymbolFont{linotext}{T1}{linotext}{m}{n} \DeclareSymbolFontAlphabet{\mathLINOTEXT}{linotext} \begin{document} $$ {\mathrm{_{{1}}^{{2}}}} $$ \end{document} )=79.7, p= Sig) while mental retardation did not occur among 46 sib controls. These exposed children were born to mothers who attempted suicide with Tardyl® between the 14th and 20th post-conceptional weeks. The components of Tardyl® used separately for a suicide attempt during pregnancy were not associated with a higher risk of mental retardation. Therefore the high doses of Tardyl® associated with the high risk for mental retardation may be due to the interaction of its three drug components.Conclusions:The findings of the study showed that the high doses of a drug containing three components may be associated with a significantly increased risk for mental retardation without any structural defects, whereas each of these three component drugs taken alone was not associated with this adverse effect.

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Section: Discussioncontrasting

confidence: 79%

A study of the risk of mental retardation among children of pregnant women who have attempted suicide by means of a drug overdose

et al. 2012

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“…The majority of studies that have assessed the impact of suicidal ideation during pregnancy on fetal development have done so in the context of self-poisoning. A series of 15 articles were published from the Budapest Monitoring System of Self-Poisoning Pregnant Women that evaluated the potential effects of large doses of drugs on fetal development among pregnant women who attempted suicide (Czeizel et al, 1997, Czeizel et al, 1999, Timmermann et al, 2009, Gidai et al, 2008c, Gidai et al, 2008a, Gidai et al, 2008d, Gidai et al, 2008b, Gidai et al, 2010, Petik et al, 2008a, Petik et al, 2008b, Petik et al, 2012, Timmermann et al, 2008b, Timmermann et al, 2008a, Timmermann et al, 2008c). With regards to congenital anomalies, the primary outcomes of these studies, no statistically significant associations were reported with self-poisoning (Czeizel et al, 1997, Czeizel et al, 1999, Timmermann et al, 2009, Gidai et al, 2008c, Gidai et al, 2008a, Gidai et al, 2008d, Gidai et al, 2008b, Gidai et al, 2010, Petik et al, 2008a, Petik et al, 2008b, Petik et al, 2012, Timmermann et al, 2008b, Timmermann et al, 2008a, Timmermann et al, 2008c).…”

Section: Resultsmentioning

confidence: 99%

Suicidal ideation in pregnancy: an epidemiologic review

Gelaye

Kajeepeta

Williams

2016

Arch Womens Ment Health

139

125

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Objective Suicidal behaviors are the leading causes of injury and death worldwide, and are leading causes of maternal deaths in some countries. One of the strongest risk factors, suicidal ideation, is considered a harbinger and distal predictor of later suicide attempt and completion, and also presents an opportunity for interventions prior to physical self-harm. The purpose of this systematic epidemiologic review is to synthesize available research on antepartum suicidal ideation. Data sources Original publications were identified through searches of the electronic databases using the search terms pregnancy, pregnant women, suicidal ideation, and pregnan* and suicid* as root searches. We also reviewed references of published articles. Study Selection We identified a total of 2,626 articles through the electronic database search. After irrelevant and redundant articles were excluded 57 articles were selected. The selected articles were original articles that focused on pregnancy and suicidal ideation. Results Of the 57 included articles, 20 reported prevalence, 26 reported risk factors, 21 reported consequences of antepartum suicidal ideation, and 5 reported on screening measures. Available evidence indicates that pregnant women are more likely than the general population to endorse suicidal ideation. Additionally, a number of risk factors for antepartum suicidal ideation were identified including intimate partner violence, <12 years education, and major depressive disorder. Conclusion There is a need for enhanced screening for antepartum suicidal ideation. The few screening instruments that exist are limited as they were primarily developed to measure antepartum and postpartum depression. Given a substantial proportion of women with suicidal ideation do not meet clinical thresholds of depression and given the stress–diathesis model that shows susceptibility to suicidal behavior independent of depressive disorders, innovative approaches to improve screening and detection of antepartum suicidal ideation are urgently needed.

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“…The teratogenic and fetotoxic effects of phenobarbital, the most frequently used barbiturates in Hungary are the subject of our ongoing study. Amobarbital was evaluated in our self-poisoning model of pregnant women (Petik, et al 2008). This paper reports the use of self-poisoning model during pregnancy in evaluation of teratogenic and fetotoxic effects of barbital, hexobarbital and butobarbital, alone or in combination with other drugs.…”

Section: Introductionmentioning

confidence: 99%

A study of the teratogenic and fetotoxic effects of large doses of barbital, hexobarbital and butobarbital used for suicide attempts by pregnant women

et al. 2008

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The teratogenic potential of barbiturates is debated. The objective of this study was to evaluate the effects of very large doses of different barbiturates, except phenobarbital and amobarbital, on fetal development in pregnant women who attempted suicide. These self-poisoned pregnant women were identified among the patients of the Department of Toxicology Internal Medicine, Korányi Hospital, Budapest. The prevalence at birth of congenital abnormalities and intrauterine fetal growth, based on pregnancy age at delivery and birth weight, as well as cognitive-behavioral status in exposed children born to mothers who attempted suicide with barbiturates alone or in combination with other drugs, during pregnancy, were compared with their sibs as controls. Of 1044 women with self-poisoning during pregnancy between 1960 and 1993, 411 delivered live-born babies; of these, 367 (89.3%) exposed children were evaluated. Of the 367 exposed children, 6, 5, 4 and 4 were born to mothers who attempted suicide with very large doses of Barbamid (butobarbital and aminophenazone), hexobarbital, butobarbital and Belloid (butobarbital, hyoscyamine and secalis cornuti alkaloida) tablets, respectively. Of 19 exposed children, two children with a congenital inguinal hernia were born to mothers who attempted suicide with 30 tablets of Belloid (900 mg butobarbital) in the 20th postconceptional week or with 20 tablets of Belloid in combination with chlordiazepoxide (100 mg) and nitrazepam (100 mg) in 12th postconceptional week. However, the critical period for production of congenital inguinal hernia is in the last months of pregnancy. None of the exposed children born to the other 12 pregnant women who attempted suicide with these barbiturates between the third and 12th postconceptional week, i.e., during the critical period for production of most major congenital abnormalities, had a congenital abnormality. Congenital abnormalities did not occur among 16 sib controls. Intrauterine fetal growth was similar between sibs and exposed children; cognitive status and behavioral scale also did not indicate any neurotoxic effects from large doses of these barbiturates. The very large doses of barbital, hexobarbital and/or butobarbital used for self-poisoning during pregnancy were not teratogenic to the children, although it must be recognized that the number of exposed children was limited.

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A study of the teratogenic and fetotoxic effects of large doses of amobarbital used for a suicide attempt by 14 pregnant women

Cited by 8 publications

References 12 publications

A study of the risk of mental retardation among children of pregnant women who have attempted suicide by means of a drug overdose

A study of the risk of mental retardation among children of pregnant women who have attempted suicide by means of a drug overdose

Suicidal ideation in pregnancy: an epidemiologic review

A study of the teratogenic and fetotoxic effects of large doses of barbital, hexobarbital and butobarbital used for suicide attempts by pregnant women

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