Drug overdose during pregnancy: an overview from a metropolitan poison control center

Suicide attempts during pregnancy usually present as intentional drug overdoses after interpersonal conflicts. During a recent four-year period, 119 (0.07%) of all 179,893 telephone inquiries at a metropolitan poison control center involved drug overdoses by 111 pregnant women. This was usually the first such attempt and telephone notification occurred primarily within the first hour. The ingested substance was known in 109 (98%) cases and consisted mostly of an excess of a single drug. The 50 different types of over-the-counter and prescription medications consisted primarily of analgesics (most notably acetaminophen), vitamins or iron, sedatives, antibiotics, and antihistamines or decongestants. No maternal deaths were reported. Signs or symptoms were nonexistent or mild in 61 (55%) women, and major or life-threatening in 50 (45%) women. Compliance with recommendations given by telephone and referral to the primary physician or emergency room was good, especially when major symptoms or life-threatening illnesses were apparent. Close emotional support and a search for depression during pregnancy and the postpartum period are recommended.