Pregnancy with epilepsy: obstetric and neonatal outcome of a controlled study.
Pregnancy with epilepsy: obstetric and neonatal outcome of a controlled study.
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DOI：
10.1016/j.seizure.2009.11.008
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发表时间：
2010-03
影响因子：
3
通讯作者：
Clayton-Smith, J.
中科院分区：
文献类型：
--
作者：
Mawer, G.;Briggs, M.;Baker, G. A.;Bromley, R.;Coyle, H.;Eatock, J.;Kerr, L.;Kini, U.;Kuzmyshcheva, L.;Lucas, S. B.;Wyatt, L.;Clayton-Smith, J.
探讨癫痫及其治疗对妊娠及其结局的影响。对照观察研究利物浦和曼彻斯特地区的国民保健服务妇产医院。277名癫痫妇女（WWE）和315名对照妇女。WWE是从产前诊所招募的。对照组的年龄和产次匹配，但胎龄不匹配。通过访谈和临床记录获得信息。主要观察指标：产科并发症、分娩方式、新生儿情况。癫痫综合征的分布与以前的调查相似。大多数WWE（67%）接受卡马西平、丙戊酸钠或拉莫三嗪单药治疗。一半的WWE在怀孕期间没有癫痫发作，但34%有强直阵挛性癫痫发作。癫痫相关的伤害是罕见的。妊娠合并产科并发症在接受治疗的癫痫患者中增加（WWTE 45%，对照组33%; p = 0.01）。大多数正常阴道分娩（WWTE 63%，对照组61%; p = 0.65）。低出生体重未增加（WWTE 6.2%，对照组5.2%; p = 0.69）。主要先天性畸形（MCM）（WWTE 6.6%，对照组2.1%; p = 0.02）和胎儿/婴儿死亡（WWTE 2.2%，对照组0.3%; p = 0.09）更多。在单药治疗中，丙戊酸盐的MCM患病率最高（11.3%; p = 0.005）。拉莫三嗪（5.4%; p = 0.23）和卡马西平（3.0%; p = 0.65）更接近对照组（2.1%）。MCM与孕前叶酸剂量无相关性。MCM在WWTE婴儿中更普遍，特别是在接受丙戊酸钠的婴儿中。
to determine the influence of epilepsy and its treatment on pregnancy and its outcome. controlled, observational study. National Health Service maternity hospitals in Liverpool and Manchester regions. 277 women with epilepsy (WWE) and 315 control women. WWE were recruited from antenatal clinics. Controls were matched for age and parity but not gestational age. Information was obtained by interview and from clinical records. Main Outcome Measures: obstetric complications, mode of delivery, condition of newborn. Distribution of epilepsy syndromes was similar to previous surveys. Most WWE (67%) received monotherapy with carbamazepine, sodium valproate or lamotrigine. Half WWE had no seizures during pregnancy but 34% had tonic clonic seizures. Seizure related injuries were infrequent. Pregnancies with obstetric complications were increased in women with treated epilepsy (WWTE 45%, controls 33%; p = 0.01). Most had normal vaginal delivery (WWTE 63%, controls 61%; p = 0.65). Low birth weight was not increased (WWTE 6.2%, controls 5.2%; p = 0.69). There were more major congenital malformations (MCM) (WWTE 6.6%, controls 2.1%; p = 0.02) and fetal/infant deaths (WWTE 2.2%, controls 0.3%; p = 0.09). Amongst monotherapies MCM prevalence was highest with valproate (11.3%; p = 0.005). Lamotrigine (5.4%; p = 0.23) and carbamazepine (3.0%; p = 0.65) were closer to controls (2.1%). There was no association between MCM and dose of folic acid preconception. MCM were more prevalent in the babies of WWTE particularly amongst those receiving sodium valproate.
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