The number of deaths decreased from 29 to 1 (odds ratio, 13.56 P =. The average number of iron ingestion calls per 1000 of all calls to poison control centers regarding children younger than 6 years decreased from 2. The incidences of iron ingestion and of iron poisoning deaths for children younger than 6 years were obtained from the annual reports of the American Association of Poison Control Centers (Washington, DC). The 10 years prior to the intervention were compared with the 5 years after its promulgation. This is a preintervention-postintervention study of the US federally mandated requirement for unit-dose packaging of iron supplements. To determine whether the requirement for unit-dose packaging of iron supplements decreases the incidence of iron ingestion and the incidence of deaths due to iron poisoning in children younger than 6 years. The US Food and Drug Administration proclaimed a regulation for unit-dose packaging of iron supplements in 1997. Iron poisoning is a major cause of unintentional poisoning death in young children. Almost half of all hospital admissions for iron poisoning in young children could be prevented by keeping iron supplements safely out of reach in the year before and after the birth of a sibling. Pregnancy is a major risk factor for iron poisoning in young children, and the period immediately after delivery is associated with the greatest risk. The postpartum year was associated with a consistently elevated risk, including an almost 4-fold increase in the risk of iron poisoning during the first postpartum month (adjusted OR 3.6, 95% CI 0.8 to 16.5).

Children whose mothers had given birth to a sibling were almost twice as likely as children whose mothers had not given birth to a sibling to be admitted for iron poisoning within 6 months of birth (adjusted odds ratio 1.9, 95% confidence interval 0.9 to 3.9). Seventeen cases (42%) occurred within a year (before or after) a sibling's birth. We studied records for 40 children admitted to hospital for iron poisoning. 31, 2000, were compared with those for the mothers of age- and sex-matched control children without iron poisoning.

Health care records for the mothers of children less than 3 years of age admitted to hospital with iron poisoning between Apr. We conducted a population-based case-control study linking health care databases in Ontario. We explored the association between iron poisoning in young children and the birth of a sibling. Because perinatal iron therapy is common, the presence of these tablets, which have a candylike appearence, in the home may pose a hazard to a mother's other young children. Iron is a leading cause of death due to poisoning in young children. Stage 3 toxicity is associated with spontaneous abortion, preterm delivery, and maternal death. or =400 mcg/dL are associated with symptomatic iron overdose. The proportions of patients treated with deferoxamine and total dosages of deferoxamine were similar by peak iron level (> or =400 vs. 6/56, respectively), or experience maternal death (3/3 vs. 1/56, respectively), deliver preterm (2/3 vs.

However, patients with stage 3 toxicity were more likely to spontaneously abort (1/3 vs. Peak iron level > or =400 mcg/dL was not associated with increased risk of spontaneous abortion, preterm delivery, congenital anomalies, or maternal death. Compared with women who had lower peak levels, women with peak serum iron levels > or =400 mcg/dL were more frequently symptomatic (12/13 vs.

Fourteen publications were identified, describing 61 cases of obstetric iron overdose, including one recent case at our institution. Statistical analysis used the Student t-test, Fisher exact test, or ANOVA, as appropriate. Two investigators independently extracted data from articles and their references including stage of toxicity (0 = asymptomatic, 1 = gastrointestinal symptoms, 2 = metabolic disturbance, 3 = organ failure), with differences resolved by consensus. A computer search of the English language literature from 1966-1998 used the key words iron toxicity, iron poisoning, deferoxamine, and pregnancy to identify peer-reviewed papers reporting intentional iron overdoses in pregnancy. The objectives of our study were to 1) determine if peak maternal serum iron level or toxicity stage after intentional overdose is associated with adverse maternal-fetal outcome, and 2) describe the use of deferoxamine antidote therapy in obstetric patients.

Iron toxicity antidote