Black widow spider envenomation in pregnancy

Abstract

Objective. Little data exist regarding the optimal treatment and outcomes of pregnancies complicated by black widow spider envenomation. Our objective is to evaluate the clinical effects, medical outcomes, and treatment differences between pregnant and nonpregnant women.

Methods. This observational study is based on a review of the database maintained by the American Association of Poison Control Centers from 2003 to 2007.

Results. Of the 12,640 human black widow spider envenomations reported at 61 poison centers in the United States, 3194 (25.3%) involved women of reproductive age, defined as age 15–45 years of age, with 97 (3.0% of reproductive-age women) being pregnant. Comparing pregnant and nonpregnant women, there were no significant differences in recommended or administered treatments. Pregnant women were more likely than nonpregnant women (OR: 1.84, 95% CI: 1.20–2.83) to have outcomes coded as minor, moderate, or major rather than no effect. Significantly higher percentages of pregnant patients were treated at a healthcare facility where they were either released (36.1% vs. 19.9%, p  < 0.001) or admitted (13.4% vs. 4.0%, p  < 0.001), than nonpregnant women. There were no documented pregnancy losses.

Conclusions. Black widow spider envenomation is a rare occurrence in pregnant women and the short-term outcomes appear to be favorable.

Keywords:

• Black widow spider
• envenomation
• pregnancy

Acknowledgements

We like to thank Jude McNally, PharmD, Michael Beuhler (Carolinas Healthcare System), MD, and Christopher P. Holstege (Division of Medical Toxicology, University of Virginia), MD, for their collaboration and providing case notes for our review. This study was partially supported by the Clinical and Translational Science Center (CTSC), University of New Mexico Health Sciences Center. Dr. Seifert is a site investigator for a Phase 3 clinical trial of Analatro(R) sponsored by Instituto Bioclon S.A. de C.V., Tlalpan, Mexico. Funding for this study was provided by Seligman Perinatal Research Endowment Fund, Department of Obstetrics and Gynecology, University of New Mexico, Albuquerque, NM.