Department of Clinical Medicine, University of Bergen, and Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway.
BJOG. 2009 Dec;116(13):1736-42. doi: 10.1111/j.1471-0528.2009.02354.x. Epub 2009 Sep 8.
To investigate whether women with epilepsy have an increased risk of complications during pregnancy and to explore the impact of antiepileptic drug (AED) use.
Population-based cohort study.
Data from Medical Birth Registry of Norway based on all births in Norway 1999-2005.
All births (n=372,128) delivered in Norway, ensured through linkage with the National Population Registry run by Statistics Norway. All singleton births and the first child in multiple pregnancies were included, leaving 365,107 pregnancies for analyses.
Pre-eclampsia (mild and severe), gestational hypertension, eclampsia, vaginal bleeding (early and late) and preterm birth.
We compared 2805 pregnancies in women with a current or past history of epilepsy (0.8%) and 362 302 pregnancies in women without a history of epilepsy. Women with epilepsy had an increased risk of mild pre-eclampsia, [odds ratio 1.3: 95% confidence interval (1.1-1.5)] and delivery before week 34 [1.2: (1.0-1.5)]. Antiepileptic drugs were used in 33.6% (n=942) of the pregnant women with epilepsy. Compared to women without epilepsy, women with epilepsy and AED use had an increased risk of mild pre-eclampsia [1.8: (1.3-2.4)], gestational hypertension [1.5: (1.0-2.2)], vaginal bleeding late in pregnancy [1.9: (1.1-3.2)], and delivery before 34 weeks of gestation [1.5: (1.1-2.0)]. No significant increase in the risk of these complications was observed in women with epilepsy not using AED. These results remained unchanged after exclusion of multiple pregnancies.
Women with epilepsy have a low complication rate, but special attention should be paid to those using AED during pregnancy.
探讨癫痫女性在妊娠期间发生并发症的风险是否增加，并探索抗癫痫药物（AED）使用的影响。
基于人群的队列研究。
数据来源于挪威医学出生登记处，基于挪威 1999-2005 年所有的分娩记录。
所有在挪威分娩的（n=372128）单胎妊娠和多胎妊娠中的第一胎均纳入研究，通过与挪威统计局管理的全国人口登记处进行链接来确保数据的完整性，共有 365107 例妊娠用于分析。
子痫前期（轻度和重度）、妊娠期高血压、子痫、阴道出血（早、晚期）和早产。
我们比较了 2805 例有当前或既往癫痫病史的妊娠（0.8%）和 362302 例无癫痫病史的妊娠。有癫痫病史的孕妇发生轻度子痫前期的风险增加[比值比 1.3：95%置信区间（1.1-1.5）]，且在 34 周前分娩的风险增加[1.2：（1.0-1.5）]。33.6%（n=942）的癫痫孕妇使用了抗癫痫药物。与无癫痫的孕妇相比，使用 AED 的癫痫孕妇发生轻度子痫前期的风险增加[1.8：（1.3-2.4）]、妊娠期高血压的风险增加[1.5：（1.0-2.2）]、妊娠晚期阴道出血的风险增加[1.9：（1.1-3.2）]，且 34 周前分娩的风险增加[1.5：（1.1-2.0）]。未发现使用 AED 的癫痫孕妇发生这些并发症的风险显著增加。排除多胎妊娠后，这些结果保持不变。
癫痫女性的并发症发生率较低，但在妊娠期间使用 AED 时应特别注意。
