Kretz R, Coban I, Gaus V, Schmitz B
Abteilung für Neurologie, Charité, Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin.
Nervenarzt. 2006 Jun;77(6):722, 724-8. doi: 10.1007/s00115-006-2082-2.
All old-generation antiepileptic drugs (AEDs) are considered to be teratogenic. In Germany, one out of 200 pregnant women (0.5%) is treated with AEDs for epilepsy. The risk of major malformations following exposure to AEDs during the first trimester of pregnancy is two to three times the rate reported in the general population, which is estimated at 2-3%. The risks associated with the treatment of epilepsy during pregnancy are therefore of major concern to all women of childbearing potential with epilepsy. Data on the comparative teratogenicity of these AEDs in humans are, however, conflicting, mainly due to inadequate sample sizes and other methodological shortcomings of previous studies. The teratogenic potential of newer AEDs is even less well known, which prevents a rational approach to AED treatment in women of childbearing potential. The European Registry of Antiepileptic Drugs and Pregnancy is a prospective international multicentre study of pregnancies with AEDs. In Germany the project was started in 2001 and so far more than 500 pregnancies have been enrolled. The enrollment rate is 4% of 4,000 pregnancies with AEDs reported annually.
所有老一代抗癫痫药物(AEDs)都被认为具有致畸性。在德国,每200名孕妇中有1名(0.5%)因癫痫接受AEDs治疗。妊娠头三个月接触AEDs后出现严重畸形的风险是一般人群报告发生率的两到三倍,一般人群发生率估计为2%-3%。因此,妊娠期间癫痫治疗相关风险是所有有生育潜力的癫痫女性主要关注的问题。然而,关于这些AEDs在人类中的相对致畸性数据相互矛盾,主要是由于先前研究样本量不足和其他方法学缺陷。新型AEDs的致畸潜力更是鲜为人知,这使得无法对有生育潜力的女性进行合理的AEDs治疗。欧洲抗癫痫药物与妊娠登记处是一项关于使用AEDs妊娠的前瞻性国际多中心研究。该项目于2001年在德国启动,迄今为止已登记了500多例妊娠。登记率为每年报告的4000例使用AEDs妊娠的4%。