Black Widow Spider Envenomation in Pregnancy
This retrospective observational study looked at the database of the American Association of Poison Control Centers between 2003 and 2007 to assess the effects of black widow spider bites during pregnancy. A total of 12 640 bites were reported during that time period. This group included 3194 women of childbearing age, defined to be between 15 and 45 years old. Ninety-seven women were pregnant and their gestational ages ranged from 4 weeks to 40 weeks. Patients' records in the database denoted the clinical outcome as mild, moderate, or major based on the reporting physicians' assessments. The authors reviewed all cases noted to be moderate or major.
Via descriptive statistics the authors determined that there was no difference in severity of outcome based on the trimester of pregnancy. Similarly, when they compared pregnant women to nonpregnant women of childbearing age, they found no difference in symptoms that were reported. No pregnancies were lost and the most common symptom was dermal irritation. Also reported were abdominal pain, muscle rigidity, and hypertension. Antivenom was used in one pregnant woman without immediate adverse effects on the fetus. The authors do remark with caution that the antivenom can cause serum sickness and that some parents might be opposed to exposing their unborn babies to the thimerosal preservative that it contains—these concerns about thimerosal are not well substantiated in scientific literature. Also, as noted in the paper, the database is not intended for clinical research, the cases are self-reported, and the identification of the spider is inferred.
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Prepared by Anil Menon, MD,