Pregnancy outcome after suicide attempt by drug use: a Danish population-based study.
BACKGROUND
It is important to study the side-effects of drugs taken during pregnancy, however the findings are difficult to interpret because of a low exposure level, uncertainty of actual drug consumption and confounding by indication. Experience from accidental or intended drug intoxications may bypass some of these methodological shortcomings. Our aim was to examine reproductive failures and child health following a single drug overdose taken prior to or during pregnancy.


METHODS
Women diagnosed with a drug intoxication during pregnancy were identified in the Regional Hospital Discharge Registry of North, Jutland from 1977 to 1999 by linkage of diagnoses for abortion and delivery with diagnoses for intoxication. Hospital medical records were reviewed to obtain data on drug use, dosage, and pregnancy outcome (legally induced abortion/miscarriages/data on birth outcome). The hospitalization history of the children was followed for a mean of 9 years with a maximum of 20 years.


RESULTS
Of 122 women studied, 44 wanted an elective abortion, 17 experienced miscarriage, and 61, exposed mainly to weak analgesics and psychotropic drugs, gave birth to 62 infants. We estimated the proportion of miscarriage to be almost doubled, whereas there was no increased risk of congenital abnormalities or prematurity in women exposed to a drug overdose compared with the background population.


CONCLUSIONS
A drug overdose shortly before or during pregnancy seems to be associated with a substantially increased risk of miscarriage, but there was no increase in fetal pathology at birth among fetuses surviving till birth.
Flint
Carolin
C
Department of Clinical Epidemiology, Aalborg and Aarhus University Hospitals, Aalborg, Denmark. uxliwi@aas.nja.dk
Larsen
Helle
H
Nielsen
Gunnar Lauge
GL
Olsen
Jørn
J
Sørensen
Henrik Toft
HT
D000022:Abortion, Spontaneous / Q000453:epidemiology* / Q000209:etiology*; D000082:Acetaminophen / Q000009:adverse effects; D000293:Adolescent; D000328:Adult; D001241:Aspirin / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D003718:Denmark / Q000453:epidemiology; D062787:Drug Overdose / Q000150:complications / Q000453:epidemiology; D005260:Female; D005315:Fetal Diseases / Q000139:chemically induced / Q000453:epidemiology; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D013287:Illicit Drugs / Q000009:adverse effects*; D007223:Infant; D007231:Infant, Newborn; D008499:Medical Records; D011247:Pregnancy; D011256:Pregnancy Outcome; D015995:Prevalence; D012042:Registries; D012189:Retrospective Studies; D019966:Substance-Related Disorders / Q000150:complications / Q000453:epidemiology*; D013406:Suicide, Attempted / Q000706:statistics & numerical data*
D013287:Illicit Drugs; D000082:Acetaminophen; D001241:Aspirin