Citation

McClure CK, Patrick TE, Katz KD, Kelsey SF, Weiss HB. J. Obstet. Gynecol. Neonatal Nurs. 2011; 40(3): 292-301.

Affiliation

PhD, is a postdoctoral scholar in the Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA. PhD, RN, is an associate professor in the College of Nursing, The Ohio State University, Columbus, OH. MD, is an assistant professor in the Department of Emergency Medicine, Division of Medical Toxicology, University of Pittsburgh Medical Center, Pittsburgh, PA. PhD, is a professor in the Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA. PhD, MPH, is a professor in the Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Denedin, New Zealand.

Copyright

(Copyright © 2011, John Wiley and Sons)

DOI

10.1111/j.1552-6909.2011.01250.x

PMID

21585527

Abstract

Objective: To describe birth outcomes following intentional acute poisoning during pregnancy. Setting: California Linked Vital Statistics-Patient Discharge Database, 2000 to 2004. Participants: Pregnant women age 15 to 44, who had a singleton live birth or fetal death that occurred between gestational ages 20 and 42 weeks who were discharged from the hospital for an intentional poisoning were compared to pregnant women discharged from the hospital for any nonpoisoning diagnosis. Intentional acute poisoning hospital discharges were identifed by the presence of an ICD-9-CM E-Codes E950-E952 (suicide, attempted suicide and self-inflicted injuries specified as intentional.) Methods: Through a retrospective cohort design, birth outcomes including low birth weight; preterm birth; fetal, neonatal, and infant death; and congenital anomalies were identified by the presence of ICD-9-CM diagnosis codes or by notation in the dataset. Results: There were 430 hospital discharges for an intentional poisoning during pregnancy documented in the dataset (rate=25.87/100,000 person years). The rate of intentional poisoning was greatest in the first weeks of gestation and declined with increasing gestational age. Analgesics, antipyretics, and antirheumatics were most commonly implicated. Adverse birth outcomes associated with intentional poisoning included preterm birth (odds ratio [OR]=1.34; 95% Confidence Interval [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]). Conclusion: Intentional acute poisoning during pregnancy was associated with several adverse birth outcomes; however, these relationships may be confounded by concomitant maternal substance abuse.

Language: en