McClure, Candace Kelly
(2008)
THE EPIDEMIOLOGY OF ACUTE POISONING HOSPITAL DISCHARGES IN WOMEN OF REPRODUCTIVE AGE AND DURING PREGNANCY AND BIRTH OUTCOMES FOLLOWING ACUTE POISONING HOSPITAL DISCHARGE DURING PREGNANCY.
Doctoral Dissertation, University of Pittsburgh.
(Unpublished)
Abstract
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.
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| Item Type: |
University of Pittsburgh ETD
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| Status: |
Unpublished |
| Creators/Authors: |
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| ETD Committee: |
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| Date: |
25 June 2008 |
| Date Type: |
Completion |
| Defense Date: |
21 April 2008 |
| Approval Date: |
25 June 2008 |
| Submission Date: |
9 April 2008 |
| Access Restriction: |
5 year -- Restrict access to University of Pittsburgh for a period of 5 years. |
| Institution: |
University of Pittsburgh |
| Schools and Programs: |
School of Public Health > Epidemiology |
| Degree: |
PhD - Doctor of Philosophy |
| Thesis Type: |
Doctoral Dissertation |
| Refereed: |
Yes |
| Uncontrolled Keywords: |
analgesics; mental illness; preterm delivery; self-inflicted injury; substance abuse |
| Other ID: |
http://etd.library.pitt.edu/ETD/available/etd-04092008-015928/, etd-04092008-015928 |
| Date Deposited: |
10 Nov 2011 19:35 |
| Last Modified: |
15 Nov 2016 13:39 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/6921 |
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