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Monitoring outcomes of suicide attempts in pregnancy can better assess drug dangers
Date:9/17/2008

P>To test their hypothesis that self-poisoned pregnant women could give useful drug-safety data, the reserachers studied outcomes of all such admissions to the Department of Toxicological Internal Medicine, Kornyi Hospital, Budapest. During the study period of 1960-1993, 1044 pregnant women were admitted and 1021 of these attempted suicide with drugs (the other 23 pregnant women had accidental intoxication due to poisonous mushroom ingestion or carbon monoxide).

Among them, these women had 411 live-born infants, and 367 exposed children were evaluated with cognitive and behavioural tests as they grew up. The test results were compared with results for siblings whose gestational periods were normal. The researchers recorded occurances of congenital abnormalities, retardation in fetal growth (the most sensitive indicator of a fetotoxic effect of drugs), rates of preterm and low birthweight babies, and the deatials of the particular drug and dose taken by mothers.

Diazepam was one of the most frequently used drugs, with 229 pregnant women using it to attempt suicide. 112 women went on to deliver live babies, 15 of whom had congenital abnormalities. However, according to the researchers, when they further analysed the doses and timing of drug ingestion, they discovered that most of the congenital abnormalities could not be considered a teratogenic effect of diazepam because the time of suicide attempts did not overlap with the critical period for producing the defects.

"Although suicide attempts with large doses of diazepam would be expected to produce an extreme pathological condition in the embryos and fetuses, such was not observed," note the authors. "Thus congenital abnormalities in the offspring of pregnant women with psychiatric disorders are mainly associated with psychiatric disorders and related lifestyle (eg, multiple alcohol and substance abuse) or their interaction, but not by diazepam itself."

Although the authors
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Contact: Mithu Mukherjee
mithu.mukherjee@sagepub.co.uk
020-732-42223
SAGE Publications UK
Source:Eurekalert

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