Department of Clinical Medicine, University of Bergen, Norway.
BJOG. 2010 Nov;117(12):1537-43. doi: 10.1111/j.1471-0528.2010.02694.x. Epub 2010 Aug 18.
To investigate whether women with epilepsy have increased risks of complications during labour, and to explore the impact of antiepileptic drug use.
Population-based cohort study.
Data from the Medical Birth Registry of 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 analysis.
Data from the Medical Birth Registry of Norway 1999-2005 were analysed.
Induction, caesarean section, use of forceps and vacuum, abnormal presentation, placental abruption, mechanical disproportion, postpartum haemorrhage, atony and Apgar score <7 after 5 minutes.
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. Antiepileptic drugs were used in 33.6% (n=942) of pregnant women with epilepsy. Women with epilepsy had an increased risk of induction [odds ratio (OR), 1.3; 95% confidence interval (CI), 1.1-1.4], caesarean section (OR, 1.4; 95% CI, 1.3-1.6) and postpartum haemorrhage (OR, 1.2; 95% CI, 1.1-1.4) compared with women without epilepsy. These rates were even higher for women with epilepsy and antiepileptic drug use, with ORs (95% CIs) of 1.6 (1.4-1.9), 1.6 (1.4-1.9) and 1.5 (1.3-1.9), respectively. In addition, the risk of an Apgar score <7 was higher (OR, 1.6; 95% CI, 1.1-2.4). For women with epilepsy without antiepileptic drug use, only a slightly increased risk of caesarean delivery was observed and no increased risk for any other complications studied.
Pregnant women with epilepsy have a low complication rate; however, they have a slightly increased risk of induction, caesarean section and postpartum haemorrhage. It is not possible to ascertain on the basis of this study whether this is a result of more severe epilepsy or antiepileptic drug use.
探讨癫痫女性在分娩期间是否有更高的并发症风险，并探索抗癫痫药物使用的影响。
基于人群的队列研究。
挪威 1999-2005 年的医学出生登记处的数据。
所有在挪威分娩的（n=372128）单胎分娩和多胎妊娠的第一胎都被纳入分析，共有 365107 例妊娠。
分析了挪威 1999-2005 年的医学出生登记处的数据。
引产、剖宫产、使用产钳和真空吸引器、异常分娩、胎盘早剥、机械性产道异常、产后出血、宫缩乏力和 Apgar 评分<7 分。
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。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，癫痫孕妇有更高的引产风险[比值比（OR），1.3；95%置信区间（CI），1.1-1.4]、剖宫产（OR，1.4；95% CI，1.3-1.6）和产后出血（OR，1.2；95% CI，1.1-1.4）风险。而癫痫孕妇且使用抗癫痫药物的风险更高，比值比（95% CI）分别为 1.6（1.4-1.9）、1.6（1.4-1.9）和 1.5（1.3-1.9）。此外，Apgar 评分<7 的风险也更高（OR，1.6；95% CI，1.1-2.4）。对于无抗癫痫药物使用的癫痫孕妇，仅观察到剖宫产风险略有增加，而研究的其他任何并发症均无增加风险。
癫痫孕妇的并发症发生率较低；然而，她们有更高的引产、剖宫产和产后出血风险。但不能确定这是由于更严重的癫痫或抗癫痫药物使用引起的。
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