A study of teratogenic and fetotoxic effects of large doses of meprobamate used for a suicide attempt by 42 pregnant women

Abstract

The human teratogenic effect of meprobamate is debated. Thus, the available data set regarding very large doses of meprobamate used for a suicide attempt during pregnancy was evaluated for effects on fetal development. Pregnant women were identified from self-poisoned subjects of a total population of approximately three million people (Budapest and surrounding region) who were admitted to the Department of Toxicology Internal Medicine, Koranyi Hospital, Budapest. Comparisons were made of congenital abnormalities, intrauterine fetal growth, and cognitive-behavioral status in exposed children born to mothers who attempted suicide with meprobamate alone or in combination with other drugs during pregnancy with their control sibs. Of 1044 women with self-poisoning during pregnancy between 1960 and 1993, 107 (10.3%) used meprobamate, with or without other drugs for a suicide attempt; 42 of these 107 women delivered live-born infants. The dose of meprobamate used for the suicide attempt ranged between 1000 and 26,000 mg, with a mean of 3690 mg. Of 42 exposed children, seven (16.7%) were affected with congenital abnormalities, however, of their 27 sib controls, four had a CA (14.8%) (OR with 95% CI: 1.7, 0.5-4.9) of 14 had a congenital abnormality. Of 14 mothers who attempted suicide during the 4-12th postconceptional week, two delivered live-born babies affected with mild isolated congenital abnormality: undescended testis and congenital dysplasia of the hip. However, the critical period for production of these two defects did not overlap with the time of the mother's suicide attempt. Mean birth weight and pregnancy age, cognitive status, and behavioral scale of the exposed children did not indicate fetotoxic, including neurotoxic, effects of large doses of meprobamate. Very large doses of meprobamate that were used for self-poisoning during pregnancy did not result in teratogenic or fetotoxic, including neurotoxic, effects on fetal development.