Eroğlu Erdal, Gökçil Zeki, Bek Semai, Ulaş U Hidir, Odabaşi Zeki
Department of Neurology, Gulhane Medical School, Ankara, Turkey.
Acta Neurol Belg. 2008 Jun;108(2):53-7.
Maternal use of antiepileptic drugs (AEDs) during pregnancy has been associated with an increased risk of congenital abnormalities in the fetus. This is partly attributable to AEDs. We aimed to analyse seizure frequency and the rate and type of any congenital malformation related to pregnancies in women with epilepsy in this prospective study. Eighty four pregnant women with epilepsy on AEDs were followed for congenital malformations. Z test was used for statistical analysis. Pregnancy did not influence the seizure frequency in 64 (76.2%) pregnancies. The seizure frequency increased in 16 (19.04%) pregnancies. In 4 (4.76%) pregnancies the number of seizures decreased during pregnancy. Overall percentage of congenital malformations in infants of mothers with epilepsy treated with AEDs was 10%, versus 3.65% in the general Turkish population. Percentages of malformations in children of pregnancies in women with epilepsy on antiepileptic drugs (AEDs) were; 6.52% (3/46) for carbamazepine (CBZ), 14.28% (2/14) for phenytoin (PHT), 13.33% (2/15)for valproic acid (VPA) and 20% (1/5) for phenobarbital (PB). This comfirms previous reports that all four AEDs (CBZ, PHT VPA, PB) are associated with an increased risk of congenital malformations, although CBZ seems to be the the safest agent in monotherapy.
孕期母亲使用抗癫痫药物（AEDs）与胎儿先天性异常风险增加有关。这部分归因于AEDs。在这项前瞻性研究中，我们旨在分析癫痫女性妊娠期间的癫痫发作频率以及与妊娠相关的任何先天性畸形的发生率和类型。对84名服用AEDs的癫痫孕妇进行先天性畸形随访。采用Z检验进行统计分析。64例（76.2%）妊娠中，妊娠未影响癫痫发作频率。16例（19.04%）妊娠中癫痫发作频率增加。4例（4.76%）妊娠中癫痫发作次数在孕期减少。服用AEDs的癫痫母亲所生婴儿的先天性畸形总体发生率为10%，而土耳其普通人群中为3.65%。服用抗癫痫药物（AEDs）的癫痫女性妊娠所生儿童的畸形发生率分别为：卡马西平（CBZ）6.52%（3/46），苯妥英（PHT）14.28%（2/14），丙戊酸（VPA）13.33%（2/15），苯巴比妥（PB）20%（1/5）。这证实了先前的报道，即所有四种AEDs（CBZ、PHT、VPA、PB）都与先天性畸形风险增加有关，尽管CBZ似乎是单药治疗中最安全的药物。
