Toxicovigilance and maternal-child health: A novel use of Poison Control Center data in evaluating toxic exposures in pregnancy

Maternal-fetal surveillance of exposures remains a significant public health need. This was an IRB- approved retrospective review of 1900 pregnancy-related cases performed using California Poison Control System records. The records from years 2006/2007 were compared to national data, which included approximately 8000 pregnancy-related calls annually. Exposure groups were divided into <19 years and > 20 years, in those cases where age was reported. In 2006, 42% of those in the 13-19 year age group were in the first trimester, 25% were in the second, and 29% were in the third. In comparison to the over 20 year group of known gestation, 33% of those were in the first trimester, 36% were in the second, and 30% were in the third. Of the 931 cases from 2007, 242 hospitalized cases of poisoning during pregnancy were reported. In the <19 years group, 52.2% were treated in a health care facility, in contrast to the 27.3% in the > 20 years age group. Overall, 87.2% were unintentional exposures and 12.8% were intentional. When compared with national data reported to the American Association of Poison Control Centers for all cases, 73.8% were unintentional and 19.5% were intentional exposures. California cases accounted for 10.5% of the pregnancy-related cases reported nationally. In utero exposures can impact lifelong health, and the health of future generations. Poison control centers offer real-time toxicovigilance, decreased recall bias, and unique opportunities for evaluating toxicity in human pregnancy that have been overlooked as a source of assisting in surveillance of maternal-child health.