Suicide Attempts with Drug Intoxication in Pregnant and Non-Pregnant Women

Objectives: Insufficient data are available comparing medical costs, hospitalization or admission rate, and drugs used for the treatment of pregnant and non-pregnant women admited to the emergency department (ED) due to suicide attempts following drug intoxication. We sought to evaluate these differences in our ED. Methods: This is a prospective, cross-sectional study; hence we attempted to follow all pregnant and non-pregnant women who were admitted in our ED at Ataturk University, Erzurum-Turkey, due to suicide attempt with drug intoxication. We have obtained records of management plans, estimated costs and hospital admission rate in the ED from 2008 to 2011 and compared in both groups. Results: A total of 309 women were registered as suicide attempts with drug intoxication. Out of these, 23 (7.4%) were pregnant and 286 (92.6%) were non-pregnant. The pregnant women had lower rate of past history of psychiatric illness as compared to non-pregnant women (4.3% vs. 26.2%; p=0.019). Comparison of drug intoxication revealed a higher rate of intake of organophosphate (39.1%; vs. 34.8% p<0.001) and paracetamol (39.1% vs. 19.9%; p=0.031), but a lower rate of multidrug ingestion (39.1% vs. 67.8%; p=0.005) in pregnant women. Furthermore, pregnant women have a lower rate of hospitalization in ED (56.5% vs. 77.6%), but higher rates of hospitalization in internal services (13% vs. 6.3%), and intensive care units (13% vs. 3.1%; p=0.039) compared to non-pregnant women. Consequently, the cost of therapy was also higher in pregnant (2553.5±6206.7 TL vs. 581.3±490.3 TL; p<0.001). Conclusions: Though pregnant women were admitted less frequently compared to non-pregnant women, suicide attempts with drug intoxication among pregnant women have increased consequences in terms of hospitalization rate and cost. Thus there is an urgent need to incorporate a special screening program to measure suicide risk followed by counseling for pregnant women during post-conceptual care.