Wolfe Michael D, Myers Orrin, Caravati E Martin, Rayburn William F, Seifert Steven A
Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM 87131-0001, USA.
J Matern Fetal Neonatal Med. 2011 Jan;24(1):122-6. doi: 10.3109/14767058.2010.481317. Epub 2010 May 12.
Little data exist regarding the optimal treatment and outcomes of pregnancies complicated by black widow spider envenomation. Our objective is to evaluate the clinical effects, medical outcomes, and treatment differences between pregnant and nonpregnant women.
This observational study is based on a review of the database maintained by the American Association of Poison Control Centers from 2003 to 2007.
Of the 12,640 human black widow spider envenomations reported at 61 poison centers in the United States, 3194 (25.3%) involved women of reproductive age, defined as age 15-45 years of age, with 97 (3.0% of reproductive-age women) being pregnant. Comparing pregnant and nonpregnant women, there were no significant differences in recommended or administered treatments. Pregnant women were more likely than nonpregnant women (OR: 1.84, 95% CI: 1.20-2.83) to have outcomes coded as minor, moderate, or major rather than no effect. Significantly higher percentages of pregnant patients were treated at a healthcare facility where they were either released (36.1% vs. 19.9%, p < 0.001) or admitted (13.4% vs. 4.0%, p < 0.001), than nonpregnant women. There were no documented pregnancy losses.
Black widow spider envenomation is a rare occurrence in pregnant women and the short-term outcomes appear to be favorable.
关于妊娠合并黑寡妇蜘蛛咬伤的最佳治疗方法和结局，现有数据较少。我们的目的是评估孕妇和非孕妇之间的临床效果、医疗结局及治疗差异。
这项观察性研究基于对美国毒物控制中心协会2003年至2007年维护的数据库的回顾。
在美国61个毒物中心报告的12640例人类黑寡妇蜘蛛咬伤病例中，3194例（25.3%）涉及育龄妇女，即年龄在15至45岁之间，其中97例（占育龄妇女的3.0%）为孕妇。比较孕妇和非孕妇，在推荐或给予的治疗方面没有显著差异。与非孕妇相比，孕妇更有可能（比值比：1.84，95%置信区间：1.20 - 2.83）出现编码为轻微、中度或重度而非无影响的结局。与非孕妇相比，在医疗机构接受治疗的孕妇中，出院（36.1%对19.9%，p ＜0.001）或入院（13.4%对4.0%，p ＜0.001）的比例显著更高。没有记录到妊娠丢失情况。
黑寡妇蜘蛛咬伤在孕妇中很少见，短期结局似乎良好。
