{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,28]],"date-time":"2025-09-28T04:20:06Z","timestamp":1759033206967},"reference-count":38,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2009,6,23]],"date-time":"2009-06-23T00:00:00Z","timestamp":1245715200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2009,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To study the effect of large doses of phenobarbital used for a suicide attempt during pregnancy for fetuses to estimate the teratogenic potential of phenobarbital.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design and setting<\/jats:title><jats:p>Comparative analysis of exposed children and their unexposed sibs born to pregnant patients who attempted suicide during pregnancy and admitted to the toxicological inpatient clinic, Budapest, 1960\u20131993.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study participants<\/jats:title><jats:p>Of 1044 self\u2010poisoned pregnant women, 88 used phenobarbital for suicide attempt and delivered newborn babies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Structural birth detects, i.e., congenital abnormalities (CAs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Doses ranged between 400 and 3000\u2009mg of phenobarbital in 88 pregnant women who attempted suicide with this drug during pregnancy and later delivered live\u2010born babies. Twelve (13.6%) of 88 exposed children and eight (10.3%) of 78 sibs were affected with CAs (odds ratios (OR) with 95%CI: 1.4, 0.6\u20133.5). Of 88 exposed children, 34 were born to mothers who attempted suicide with phenobarbital between the 3rd and 12th postconceptional weeks, the critical period of most CAs; 3 had CAs (diaphragmatic defect, multiple CA, undescended testis), but only diaphragmatic defect might be associated with phenobarbital used for suicide attempt.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The use of phenobarbital once but extremely large doses in non\u2010epileptic pregnant women does not seem to pose a significant risk for CAs. Our experiences show the feasibility and benefits of the disaster epidemiological self\u2010poisoning model for estimating human teratogenic risks of drug exposure. 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