ANTICONVULSANTS, FOLATE LEVELS, AND PREGNANCY OUTCOME - A PROSPECTIVE-STUDY
ANTICONVULSANTS, FOLATE LEVELS, AND PREGNANCY OUTCOME - A PROSPECTIVE-STUDY
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DOI：
10.1002/ana.410210210
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发表时间：
1987-02-01
影响因子：
11.2
通讯作者：
ANDERMANN, F
中科院分区：
文献类型：
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作者：
DANSKY, LV;ANDERMANN, E;ANDERMANN, F
血清和红细胞中的叶酸水平，通过使用干酪乳杆菌的微生物测定法测定，以及血浆抗惊厥药浓度同时监测非妊娠（50例受试者）和妊娠（46例受试者中49例妊娠）癫痫妇女。23例（46%）非妊娠妇女血清叶酸水平低于正常，4例（8%）非妊娠妇女红细胞叶酸水平低于正常。在没有服用叶酸补充剂的孕妇中，叶酸缺乏症的发生率随着妊娠的进展而增加。服用叶酸补充剂的孕妇达到正常或超正常的血液叶酸浓度。在非妊娠和妊娠妇女中，血清和红细胞叶酸水平与苯妥英钠和苯巴比妥的血浆浓度以及抗惊厥药物的数量呈负相关。在49例妊娠中，有10例异常结局（20.4%）：4例自然流产（8.2%）和6例儿童严重先天畸形（12.2%）。妊娠结局异常者的血叶酸水平显著低于妊娠结局正常者。结果提示抗惊厥药、叶酸和不良妊娠结局之间存在剂量反应关系。
Folate levels in serum and red cells, as determined by a microbiological assay using Lactobacillus casei, and plasma anticonvulsant concentrations were monitored concurrently in nonpregnant (50 subjects) and pregnant (49 pregnancies in 46 subjects) epileptic women. Twenty-three (46%) nonpregnant women had subnormal serum folate levels and 4 nonpregnant women (8%) showed subnormal red cell folate levels. In pregnant women not taking folate supplements, the incidence of folate deficiency increased as the pregnancy advanced. Pregnant women taking folate supplements achieved normal or supranormal blood folate concentrations. In both nonpregnant and pregnant women, serum and red cell folate levels were inversely correlated with plasma concentrations of phenytoin and of phenobarbital, and with the number of anticonvulsants. In 49 pregnancies, there were 10 abnormal outcomes (20.4%): 4 spontaneous abortions (8.2%) and 6 children with major congenital malformations (12.2%). Blood folate levels were significantly lower in pregnancies with an abnormal outcome than in those with a normal outcome. The results suggest a dose-response relationship among anticonvulsants, folate, and adverse pregnancy outcome.