Scorpion stings in pregnancy: an analysis of outcomes in 66 envenomed pregnant patients in Iran

Abstract

Background: Scorpionism is one of the most important health problems in tropical regions, which unfortunately results in thousands of deaths annually. Pregnant women are potential victims in areas with high scorpion-sting prevalence. Limited medical data are available on the effects of scorpion envenomation in pregnant women. This study aimed to examine the effect of scorpion envenomation on pregnancy outcomes in 66 cases. Methods: The present descriptive/analytical cross-sectional study was performed on 66 scorpion-envenomed pregnant women referred to the clinical toxicology unit of Ahvaz Razi Hospital in Iran during 2015-2017. The variables assessed in all cases, via questionnaire and hospital medical records, were: age, patient residency, gestational week, status of the fetus, laboratory anomalies, clinical severity of envenomation, sting site and scorpion species. Pregnancy outcome (miscarriage, stillbirth, preterm birth, normal delivery) and status of the newborns were also evaluated. Data were analyzed using SPSS® software (version 24.0). Results: The following pregnancy outcomes were recorded from envenomed pregnant women: miscarriage = 1.5% (n = 1), stillbirth = 4.5% (n = 3), preterm birth = 10.6% (n = 7), normal birth = 83% (n = 55). Among participants whose pregnancy led to birth, 11(17.7%) cases had prenatal-neonatal complications. Neonatal complications, including Apgar score less than 8 points at 5 min, were found in 7 (11.3%) preterm birth cases and in 4 (6.4%) normal birth cases, along with birth weight below 2500 g in normal births. A significant relationship was found between adverse pregnancy outcomes and bite location, as well as scorpion species, but no relationship was found with other variables. Conclusion: Envenomation significantly contributes to preterm birth. Moreover, the location of bites and the type of scorpion species have a decisive role in the pregnancy outcome of scorpion-envenomed pregnant women.

Effects of climate variables on the incidence of scorpion stings in Iran for five years

“…Thus, they are known as nest makers and diggers [ 6 - 8 ]. Some of them have adapted themselves to be active in or around human residential areas, thereby increasing the probability of their encounters with humans [ 9 ]. Scorpions are opportunistic predators concerning selecting their habitat and using any natural, artificial or human-made spaces and gaps for hiding and survival [ 10 ].…”

French Scorpionism (Mainland and Oversea Territories): Narrative Review of Scorpion Species, Scorpion Venom, and Envenoming Management

“…However, some studies conducted in other countries and on other species of scorpion suggest that caution should be exercised. Indeed, in the case of delivery triggered by envenoming, it has been described, in Iran, that stillborn babies have been delivered from 22 to 30 weeks due to amenorrhea [ 130 ]. This premature delivery is not due to vascular suffering.…”

“…At birth, fetal distress may be observed in 6 to 11% of births. In utero growth retardation has also been described with rare cases of infants with a low birth weight [ 130 ]. These complications are rare and have only been described in Iran after envenoming by Hemiscorpius lepturus [ 130 , 131 , 132 , 133 ].…”

“…In utero growth retardation has also been described with rare cases of infants with a low birth weight [ 130 ]. These complications are rare and have only been described in Iran after envenoming by Hemiscorpius lepturus [ 130 , 131 , 132 , 133 ]. On the maternal side, an exceptional case of eclampsia has been described in Turkey [ 134 ].…”

“…On the maternal side, an exceptional case of eclampsia has been described in Turkey [ 134 ]. Scorpionic envenoming during pregnancy or the use of antivenom does not appear to have fetotoxicity (assessed up to the 12th month of life) [ 130 , 131 ].…”