Reproduction and genetic causal attribution of epilepsy.
Reproduction and genetic causal attribution of epilepsy.
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这项研究解决了遗传学相关的问题，减少生育癫痫患者的贡献。调查完成了606名成人癫痫患者的原因不明，在我们的医疗中心。采用Poisson回归分析方法分析了子代数与以下因素的关系：（1）遗传属性（正式发布日期：参与者认为遗传学是导致他们癫痫的原因），通过从四个调查项目开发的新量表进行评估（Cronbach's alpha = .89），（2）参与者对癫痫父母子女癫痫风险的估计（1%，5%-10%，25%，和50%-100%），和（3）参与者的报告，他们的生育决定的影响，“有一个孩子患有癫痫的机会”（无/弱/中度，强/非常强）。对年龄、教育、种族/民族、宗教、癫痫类型（全身性、局灶性和两者/不可分类）和癫痫发作时的年龄（<10岁、10-19岁和≥20岁）进行了调整。在18-45岁的参与者中，后代的数量随着GA的增加而显著减少（最高与最低GA四分位数比率[RR] = 0.5，p <0.001），并增加后代的估计癫痫风险（以5%-10%作为参考，因为它最接近真实值，25%的RR：.7，p = .05; 50%-100%的RR：.6，p = .03）。后代的数量是不相关的报告的影响，“有一个孩子患有癫痫的机会”对生育决定。在>45岁的参与者中，根据GA四分位数或估计的后代癫痫风险，后代的数量没有显著差异。然而，那些报告对他们的生育决定有强烈/非常强烈影响的“有癫痫孩子的机会”的人只有60%的后代。这些发现表明，高估后代患癫痫的风险可能对癫痫患者产生重要后果。鉴于复发风险和基因检测对生殖决策的潜在影响，对患者和提供者进行有关复发风险和基因检测选项的教育至关重要。
This study addresses the contribution of genetics-related concerns to reduced childbearing among people with epilepsy. Surveys were completed by 606 adult patients with epilepsy of unknown cause at our medical center. Poisson regression analysis was used to assess the relations of number of offspring to: (1) genetic attribution (GA: participants’ belief that genetics was a cause of their epilepsy), assessed via a novel scale developed from four survey items (Cronbach’s alpha = .89), (2) participants’ estimates of epilepsy risk in the child of a parent with epilepsy (1%, 5%–10%, 25%, and 50%–100%), and (3) participants’ reports of the influence on their reproductive decisions of “the chance of having a child with epilepsy” (none/weak/moderate, strong/very strong). Analyses were adjusted for age, education, race/ethnicity, religion, type of epilepsy (generalized, focal, and both/unclassifiable), and age at epilepsy onset (<10, 10–19, and ≥20 years). Among participants 18–45 years of age, the number of offspring decreased significantly with increasing GA (highest vs lowest GA quartile rate ratio [RR] = .5, p < .001), and increasing estimated epilepsy risk in offspring (with 5%–10% as referent because it is closest to the true value, RR for 25%: .7, p = .05; RR for 50%–100%: .6, p = .03). Number of offspring was not related to the reported influence of “the chance of having a child with epilepsy” on reproductive decisions. Among participants >45 years of age, the number of offspring did not differ significantly according to GA quartile or estimated offspring epilepsy risk. However, those reporting a strong/very strong influence on their reproductive decisions of “the chance of having a child with epilepsy” had only 60% as many offspring as others. These findings suggest that overestimating the risk of epilepsy in offspring can have important consequences for people with epilepsy. Patient and provider education about recurrence risks and genetic testing options to clarify risks are critical, given their potential influence on reproductive decisions.
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影响因子：
5.6
作者：
Sorge ST;Hesdorffer DC;Phelan JC;Winawer MR;Shostak S;Goldsmith J;Chung WK;Ottman R
通讯作者：
Ottman R
影响因子：
4.8
作者：
通讯作者：
--
影响因子：
5
作者：
Artama, M;Isojärvi, JIT;Auvinen, A
通讯作者：
Auvinen, A
影响因子：
2.6
作者：
Vazquez, Blanca;Gibson, Patricia;Kustra, Robert
通讯作者：
Kustra, Robert
影响因子：
5.6
作者：
Hesdorffer DC;Caplan R;Berg AT
通讯作者：
Berg AT