Czeizel Andrew E
Foundation for the Community Control of Hereditary Diseases, Budapest, Hungary.
J Inj Violence Res. 2011 Jan;3(1):45-54. doi: 10.5249/jivr.v3i1.77.
The aim of the Budapest Monitoring System of Self-Poisoning Pregnant Women was to evaluate the potential congenital abnormality inducing effect of extremely large doses of drugs among pregnant women who attempted suicide. This system was appropriate to describe the characteristics of these pregnant women as a secondary finding from this model.
All self-poisoned patients were cared for at a toxicological inpatient clinic in Budapest, between 1960 and 1993. Of a total of 1,044 pregnant women identified from the three different periods of the project, only 19 (1.8%) died. Women who survived were visited at home to reveal birth outcomes, and their exposed children were examined medically to identify congenital abnormalities and tested to estimate their cognitive-behavioral status. The previous or subsequent children of these pregnant women were used as controls with a similar examination protocol.
In general, self-poisoned pregnant women were young (peak age was between 18 and 20 years), 62% had their first pregnancy, 55% were unmarried, they had lower socioeconomic status, 46% were smokers and 22.5% drinkers, but depression/panic disorder occurred only among 17 pregnant women. Suicide attempts with drugs were most frequent in the fourth post-conceptional week and second month of pregnancy. In general they used smaller doses of drugs for suicide than non-pregnant age-matched women. Of 1,044 self-poisoned pregnant women, 926 had known pregnancy outcomes and 411 (44.4%) delivered live-born babies.
The self-poisoning model appears to have several benefits (e.g., dose-response estimation of drugs) in comparison with other methods when evaluating teratogenic/fetotoxic effect of drugs. It is suggested that an international monitoring system of self-poisoned pregnant women should be established to provide a larger data base.
布达佩斯孕妇自杀中毒监测系统的目的是评估企图自杀的孕妇服用超大剂量药物对胎儿潜在的致畸作用。该系统适合描述这些孕妇的特征，作为该模型的次要发现。
1960年至1993年间，所有自杀中毒患者均在布达佩斯的一家毒理学住院诊所接受治疗。在该项目三个不同时期确定的1044名孕妇中，只有19人（1.8%）死亡。对幸存的妇女进行了家访以了解分娩结局，并对其接触药物的子女进行了医学检查，以确定是否存在先天性异常，并进行测试以评估其认知行为状态。这些孕妇之前或之后生育的子女作为对照，采用类似的检查方案。
一般来说，自杀中毒的孕妇较为年轻（峰值年龄在18至20岁之间），62%为首次怀孕，55%未婚，社会经济地位较低，46%吸烟，22.5%饮酒，但只有17名孕妇出现抑郁/惊恐障碍。药物自杀企图在妊娠第4周和妊娠第2个月最为常见。一般来说，她们自杀时使用的药物剂量比年龄匹配的非孕妇要小。在1044名自杀中毒的孕妇中，926人已知妊娠结局，411人（44.4%）分娩活婴。
与其他方法相比，自杀中毒模型在评估药物的致畸/胎儿毒性作用时似乎有几个优点（例如，药物的剂量反应估计）。建议建立一个国际孕妇自杀中毒监测系统，以提供更大的数据库。
