The teratogenic potential of
barbiturates is debated. The objective of this study was to evaluate the effects of very large doses of different
barbiturates, except
phenobarbital and
amobarbital, on fetal development in pregnant women who attempted suicide. These self-poisoned pregnant women were identified among the patients of the Department of Toxicology Internal Medicine, Korányi Hospital, Budapest. The prevalence at birth of
congenital abnormalities and intrauterine fetal growth, based on pregnancy age at delivery and
birth weight, as well as cognitive-behavioral status in exposed children born to mothers who attempted suicide with
barbiturates alone or in combination with other drugs, during pregnancy, were compared with their sibs as controls. Of 1044 women with self-
poisoning during pregnancy between 1960 and 1993, 411 delivered live-born babies; of these, 367 (89.3%) exposed children were evaluated. Of the 367 exposed children, 6, 5, 4 and 4 were born to mothers who attempted suicide with very large doses of Barbamid (
butobarbital and
aminophenazone),
hexobarbital,
butobarbital and
Belloid (
butobarbital,
hyoscyamine and secalis cornuti alkaloida)
tablets, respectively. Of 19 exposed children, two children with a congenital
inguinal hernia were born to mothers who attempted suicide with 30
tablets of
Belloid (900 mg
butobarbital) in the 20th postconceptional week or with 20
tablets of
Belloid in combination with
chlordiazepoxide (100 mg) and
nitrazepam (100 mg) in 12th postconceptional week. However, the critical period for production of congenital
inguinal hernia is in the last months of pregnancy. None of the exposed children born to the other 12 pregnant women who attempted suicide with these
barbiturates between the third and 12th postconceptional week, i.e., during the critical period for production of most major
congenital abnormalities, had a
congenital abnormality.
Congenital abnormalities did not occur among 16 sib controls. Intrauterine fetal growth was similar between sibs and exposed children; cognitive status and behavioral scale also did not indicate any neurotoxic effects from large doses of these
barbiturates. The very large doses of
barbital,
hexobarbital and/or
butobarbital used for self-
poisoning during pregnancy were not teratogenic to the children, although it must be recognized that the number of exposed children was limited.