Poisoning is the leading cause of injury hospitalization among women of reproductive age and the third leading cause of injury hospitalization during pregnancy. The California Patient Discharge Dataset and Vital Statistics-Patient Discharge Database were utilized to identify cases of acute poisoning hospital discharges. Studies were conducted to determine the epidemiology of acute poisoning hospital discharges in women of reproductive age and during pregnancy and to investigate the effects of acute poisoning during pregnancy on birth outcomes.
Pregnancy was associated with a lower risk for acute poisoning hospital discharge (OR=0.89, p=0.0007). Acute poisoning hospital discharges were greatest among young black women, and in women with substance abuse and mental health problems, regardless of pregnancy status. Analgesic and psychiatric medications were most commonly implicated in acute poisoning hospital discharges among women of reproductive age and during pregnancy. The majority of poisonings among women of reproductive age and among pregnant women were self-inflicted.
Adverse birth outcomes associated with acute poisoning include preterm delivery (PTD), respiratory distress, cesarean delivery, and other cardiac congenital anomalies. Infants born to women delivering at their poisoning hospitalization exhibited higher rates of respiratory distress and PTD. In the later-delivery group, infants born to women with an acute poisoning during pregnancy were at a greater risk of PTD and other cardiac congenital anomalies.
Adverse birth outcomes associated with intentional acute poisoning include PTD and low birth weight (LBW). Infants born to women that were discharged for an intentional acute poisoning hospital discharge within the first nine weeks of gestation exhibited higher rates of LBW. Among women who were discharged between gestational weeks 10 and delivery, intentional acute poisoning was associated with higher rates of circulatory system congenital anomalies.
Although the etiologies of the reported adverse outcomes are speculative, it can be suggested that substance abuse or other risk-taking behaviors associated with acute poisoning may confound the relationship between poisoning and congenital anomalies.
The public health significance of this dissertation is that these results provide public health practitioners the information necessary to design programs to reduce the burden of poisonings in women and their infants.
| Identifer | oai:union.ndltd.org:PITT/oai:PITTETD:etd-04092008-015928 |
| Date | 25 June 2008 |
| Creators | McClure, Candace Kelly |
| Contributors | Kenneth D. Katz, MD, Thelma Patrick, PhD, RN, Sheryl F. Kelsey, PhD, Harold (Hank) B. Weiss, PhD, MPH |
| Publisher | University of Pittsburgh |
| Source Sets | University of Pittsburgh |
| Language | English |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://etd.library.pitt.edu/ETD/available/etd-04092008-015928/ |
| Rights | restricted, I hereby certify that, if appropriate, I have obtained and attached hereto a written permission statement from the owner(s) of each third party copyrighted matter to be included in my thesis, dissertation, or project report, allowing distribution as specified below. I certify that the version I submitted is the same as that approved by my advisory committee. I hereby grant to University of Pittsburgh or its agents the non-exclusive license to archive and make accessible, under the conditions specified below, my thesis, dissertation, or project report in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also retain the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report. |
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