Birth Outcomes Following Self‐Inflicted Poisoning During Pregnancy, California, 2000 to 2004

McClure, Candace K.; Patrick, Thelma E.; Katz, Kenneth D.; Kelsey, Sheryl F.; Weiss, Harold B.

doi:10.1111/j.1552-6909.2011.01250.x

Cited by 16 publications

(6 citation statements)

References 23 publications

(34 reference statements)

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“…Agents Encountered Because the majority of cases in the registry were intentional exposures, the agent classes encountered are comparable to those found in studies on attempted suicide during pregnancy, which primarily involved nonopioid analgesics (mainly acetaminophen) and sedative-hypnotics/muscle relaxants [8,9,[15][16][17]. The breakdown of agents ingested by pregnant women also mirrors that reported in the registry for the entire population [5].…”

Section: Discussionsupporting

confidence: 51%

See 1 more Smart Citation

Acute Poisoning During Pregnancy: Observations from the Toxicology Investigators Consortium

et al. 2015

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Acute poisonings during pregnancy pose a particular challenge to health care providers because of the potential for an immediate life threat or possible life-long implications for both the mother and fetus, including teratogenicity of the poison or its antidote. We describe recent consequential exposures among pregnant women in the USA. We identified all poisoning cases involving pregnant women that were catalogued by the medical toxicology services across the 37 sites of the Toxicology Investigators Consortium (ToxIC) Registry of the American College of Medical Toxicology between January 2010 and December 2012. Of 17,529 exposure cases reported in the ToxIC Registry, 103 (0.6 %) involved pregnant women, 80 % of whom were symptomatic and about a quarter displayed a specific toxidrome. The majority of cases (n = 53; 51.5 %) involved intentional exposures, most commonly to pharmaceutical agents, followed by unintentional pharmaceutical exposures (10 %) and withdrawal syndromes (9 %). Non-opioid analgesics were the most common class of agents encountered (31 %), followed by sedative-hypnotics/muscle relaxants (18 %), opioids (17 %), anti-convulsants (10 %), and anti-depressants (10 %). Over a third of cases involved exposure to multiple substances, and 32 % involved exposure to more than one drug class. The most commonly administered antidotes were N-acetylcysteine (23 %), sodium bicarbonate (10 %), flumazenil (4 %), and physostigmine (4 %). About half of acute poisoning cases among pregnant women presenting for emergency care involved intentional exposures, mostly with over-the-counter analgesics and psychoactive medications. Clinicians should be cognizant of the unique circumstances, maternal and fetal risks, and management principles of the acutely poisoned pregnant woman.

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Section: Discussionsupporting

confidence: 51%

“…The majority of such episodes are impulsive and frequently precipitated by violent interpersonal disputes [12]. The peak time reported for self-harm attempts in pregnancy is the first trimester, after which, it declines with advanced gestational age [8,9,11,[13][14][15].…”

Section: Discussionmentioning

confidence: 99%

Acute Poisoning During Pregnancy: Observations from the Toxicology Investigators Consortium

et al. 2015

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“…For instance, Gandhi et al (Gandhi et al, 2006) found that infants born to women who attempted suicide during pregnancy were more likely to be low birth weight (<2500 g) (OR=1.25, 95% CI: 1.08–1.44) and have respiratory distress syndrome (OR=1.41, 95% CI: 1.07–1.86). McClure et al (McClure et al, 2011) reported that risks for preterm birth (OR=1.34, 95% CI: 1.01–1.77), low birth weight (OR=1.49, 95% CI: 1.04–2.12), and circulatory system congenital anomalies (OR=2.17, 95% CI: 1.02–4.59) were elevated among gravidas who attempted self-poisoning during pregnancy as compared with those who did not. Regarding suicidal ideation more broadly, Hodgkinson et al (Hodgkinson et al, 2010) found that infants of mothers reporting depressive symptoms with suicidal ideation weighed 239.5 g (95% CI: 3.9–475.1) less on average than infants born to mothers reporting depressive symptoms without suicidal ideation.…”

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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“…Low infant birth weight was significantly associated with completed suicide and marginally associated with attempted suicide. In addition, Candance et al (2011) determined that low birth weight was associated with intentional poisoning in California 48 . Furthermore, Schiff and Grossman 37 found that low birth weight was associated with attempted suicide, but the association was nonsignificant after adjustment for main factors 37 , which is consistent with our results.…”

Section: Discussionmentioning

confidence: 99%

Factors influencing attempted and completed suicide in postnatal women: A population-based study in Taiwan

Weng

Chang

Yeh

et al. 2016

Sci Rep

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The aims of study were to investigate risk factors associated with attempted and completed suicide. This nested case–control study was conducted using the medical and death data of nearly all pregnant women for the period 2002–2012 in Taiwan. A total of 139 cases of attempted suicide and 95 cases of completed suicide were identified; for each case, 10 controls were randomly selected and matched to the cases according to age and year of delivery. A conditional logistic regression model was used. The mean attempted and completed suicide rates were 9.91 and 6.86 per 100,000 women with live births, respectively. Never having married and postpartum depression also increased the risk of attempted suicide (OR = 2.06; 95% CI = 1.09–3.88 and OR = 2.51; 95% CI = 1.10–5.75, respectively) and completed suicide (OR = 20.27; 95% CI = 8.99–45.73 and OR = 21.72; 95% CI = 8.08–58.37, respectively). Other factors for attempted suicide included being widowed or divorced, and having a caesarean delivery or suicide history. Other factors for completed suicide included lower education level, low infant birth weight, and diagnosis of anxiety or mood disorder. These results suggest that people should appropriately assess potential risk factors and provide assistance for postnatal women to reduce the occurrence of suicide events.

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Birth Outcomes Following Self‐Inflicted Poisoning During Pregnancy, California, 2000 to 2004

Cited by 16 publications

References 23 publications

Acute Poisoning During Pregnancy: Observations from the Toxicology Investigators Consortium

Acute Poisoning During Pregnancy: Observations from the Toxicology Investigators Consortium

Suicidal ideation in pregnancy: an epidemiologic review

Factors influencing attempted and completed suicide in postnatal women: A population-based study in Taiwan

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