The Epidemiology of Acute Poisonings in Women of Reproductive Age and During Pregnancy, California, 2000–2004

Abstract

The aims of this study were to describe and compare the epidemiology of acute poisoning hospital discharges in women of reproductive age and during pregnancy (aged between 15 and 44) to include the incidence rate, risk factors, substances involved, rates of intentional versus unintentional poisonings, and in pregnant women, distribution over trimesters. Through a cohort study design, the California patient discharge dataset and linked vital statistics-patient discharge database were used to identify cases of acute poisoning hospital discharges from 2000 to 2004 among women of reproductive age and among pregnant women. Odds ratios (OR) were calculated to identify risk factors using logistic regression. Of 4,436,019 hospital discharges in women of reproductive age, 1% were for an acute poisoning (115.3/100,000 person-years). There were 2,285,540 deliveries and 833 hospital discharges for an acute poisoning during pregnancy (48.6/100,000 person-years). Pregnancy was associated with a lower risk of acute poisoning (OR = 0.89, P = 0.0007). Poisonings were greatest among young black women regardless of pregnancy status and among those with substance abuse or mental health problems. Analgesic and psychiatric medications were most commonly implicated. The majority of poisonings among women of reproductive age (69.6%) and among pregnant women (61.6%) were self-inflicted. Efforts to reduce acute poisonings among women of reproductive age should include education regarding the use of over-the-counter medications and interventions to reduce self-inflicted harm.

Unintentional Chronic Acetaminophen Poisoning During Pregnancy Resulting in Liver Transplantation

“…APAP is the most common drug implicated in overdoses during pregnancy [2]. The vast majority of the reported cases of APAP toxicity during pregnancy involve single, large acute ingestions and the reported outcomes are usually favorable if NAC therapy is initiated in a timely fashion [3].…”

“…Unfortunately, APAP is also among the most commonly reported agents implicated in overdoses during pregnancy [2]. We present a unique case of a pregnant patient with fulminant hepatic failure resulting in a liver transplant from repeated supratherapeutic ingestions of APAP.…”

Is there any difference of suicide attempts with drug intoxication in between pregnant and non-pregnant women?

“…4 Hastalarımızdan 23 yaşında organofosfat zehirlenmesi ile başvuran bir gebe anestezi yoğun bakım ünitesine yatırıldık-tan 10 gün sonra hayatını kaybetmiştir. Çalışmamızda gebelerde mortalite oranı %4.4'dür.…”

“…[3] 2000'li yıllarda gebe hastaların hastaneye yatış nedenleri arasında motorlu trafik kazaları ve düşmelerden sonra zehirlenmeler %16.4 ile 3. sı-rada yer almaktayken günümüzde bu oran %31 ile ilk sıraya yükselmiştir. [4,5] Toplumda kadınlar arasında ölümcül olmayan kendine zarar verme davranış tipi olarak en sık zehirlenmeler görülmektedir. [4,6] Ülkemizde gebelik döneminde görülen intihar girişimleriyle ilgili yeterli çalışma bulunmamaktadır.…”

“…[4,5] Toplumda kadınlar arasında ölümcül olmayan kendine zarar verme davranış tipi olarak en sık zehirlenmeler görülmektedir. [4,6] Ülkemizde gebelik döneminde görülen intihar girişimleriyle ilgili yeterli çalışma bulunmamaktadır. Çalışmanın ilk sonlanım noktası acil servise intihar amaçlı ağız yoluyla aşırı ilaç alımı nedeniyle başvuran gebe hastalar ile aynı yaş grubunda intihar amaçlı ağız yoluyla aşırı ilaç alımı nedeniyle başvu-ran gebe olmayan kadın hastaların yatış oranlarını, zehirlendiği ilaç tiplerini ve maliyet farklarını karşılaştırmaktır.…”