Chen Yi-Hua, Chiou Hung-Yi, Lin Herng-Ching, Lin Hsiu-Li
School of Public Health, Taipei Medical University, Taipei, Taiwan.
Arch Neurol. 2009 Aug;66(8):979-84. doi: 10.1001/archneurol.2009.142.
To assess whether seizures in women with epilepsy during pregnancy contribute to adverse pregnancy outcomes.
A retrospective cross-sectional study.
Taiwan. Patients This study linked 2 nationwide population-based data sets: Taiwan's birth certificate registry and the Taiwan National Health Insurance Research Data set. A total of 1016 women with epilepsy were selected who had single births from 2001 to 2003 and who had been diagnosed with epilepsy within 2 years prior to their index delivery, together with 8128 matched women without chronic disease as a comparison cohort. Women with epilepsy were further stratified into 2 groups for analysis: women who did and did not have seizures during pregnancy.
Low-birth-weight infants, preterm delivery, and infants who are small for gestational age (SGA).
Compared with women without epilepsy, epileptic seizures during pregnancy were independently associated with a 1.36-fold (95% confidence interval [CI], 1.01-1.88), 1.63-fold (95% CI, 1.21-2.19), and 1.37-fold (95% CI, 1.09-1.70) increased risk of low-birth-weight infants, preterm delivery, and SGA, respectively, after adjusting for family income and parental and infant characteristics. Further, the risk of SGA increased significantly (odds ratio, 1.34; 95% CI, 1.01-1.84) for women with seizures during pregnancy compared with women with epilepsy who did not have seizures during pregnancy.
We suggest preventing seizures during pregnancy as an essential step to reduce risk of adverse pregnancy outcomes.
评估癫痫女性孕期发作是否会导致不良妊娠结局。
一项回顾性横断面研究。
台湾。患者 本研究将两个全国性基于人群的数据集相链接：台湾出生证明登记处和台湾国民健康保险研究数据集。共选取了1016例癫痫女性，她们在2001年至2003年期间单胎分娩，且在其索引分娩前2年内被诊断为癫痫，同时选取8128例匹配的无慢性病女性作为对照队列。癫痫女性进一步分为两组进行分析：孕期有发作和无发作的女性。
低体重儿、早产和小于胎龄儿（SGA）。
与无癫痫女性相比，在调整家庭收入、父母及婴儿特征后，孕期癫痫发作分别独立增加了低体重儿、早产和SGA的风险，风险分别增加1.36倍（95%置信区间[CI]，1.01 - 1.88）、1.63倍（95% CI，1.21 - 2.19）和1.37倍（95% CI，1.09 - 1.70）。此外，与孕期无发作的癫痫女性相比，孕期有发作的女性SGA风险显著增加（优势比，1.34；95% CI，1.01 - 1.84）。
我们建议预防孕期发作是降低不良妊娠结局风险的关键步骤。
