Surveillance of Pregnancy with Suicidal Intent: A Need for Interdisciplinary Tracking

Surveillance of maternal-fetal exposures due to suicidal intent is a significant public health need. The purpose of this study was to retrospectively review pregnancy-related cases from the California Poison Control System (CPCS) from the years 2006 and 2007, as part of an ongoing study of maternal-fetal exposures. This was an IRB- approved retrospective review of pregnancy-related cases (n=1900). Exposure groups were divided into <19 years and >20 years, in those cases where age was reported. Of the 931 cases from 2007, 242 hospitalized cases of poisoning during pregnancy were reported. Increased rates of hospitalization were reported in the <19 year age group (52.2%), compared to (27%) in the >20 year age group. Seventy percent in the <19 year old group were reported as suicidal intent, compared to 44% in the >20 year old group. Substances of exposure included: anti-seizure medications, benzodiazepines, insulin, drugs of abuse,and over-the-counter analgesics. Exposures included intravaginal, oral, dermal,and ocular routes. Hospitalized cases were followed to stabilization, however, no maternal or perinatal tracking was continued to outcome by the CPCS due to limitations on scope and resources. An interdisciplinary approach to surveillance and follow-up of maternal-fetal exposures needs to be addressed in the public health community; in order to ascertain the full measure of intentional exposures and morbidity that occurs during the perinatal period.