Bánhidy Ferenc, Puhó Erzsébet H, Czeizel Andrew E
Second Department of Obstetrics and Gynecology, School of Medicine, Semmelweis University, Budapest, Hungary.
Congenit Anom (Kyoto). 2011 Mar;51(1):34-42. doi: 10.1111/j.1741-4520.2010.00300.x.
The objective of the present study was to check the efficacy of progress in the medical care of epileptic pregnant women on the basis of the reduction of different congenital abnormalities (CAs) in their offspring. First, the prevalence of medically recorded epilepsy was compared in 95 pregnant women who later had offspring with different CAs (case group) and 90 pregnant women who later delivered newborn infants without CA (control group) and matched to cases in the Hungarian Case-Control Surveillance System of Congenital Abnormalities, 1980-1996. Second, the rate of different CAs was compared in the offspring of epileptic pregnant women between 1980 and 1989 and 1990-1996. Cleft lip with or without cleft palate, cleft palate, cardiovascular CAs, oesophageal atresia/stenosis, hypospadias and multiple CAs showed a higher risk in the offspring of pregnant women with epilepsy treated with different antiepileptic drugs, explained mainly by polytherapy. There was no higher risk for total CAs after monotherapy. There was no significantly lower rate of total CAs in the offspring of epileptic pregnant women during the second period of the study. The efficacy of special medical care of epileptic pregnant women was not shown on the basis of decrease in the rate of CAs in the offspring of epileptic pregnant women.
本研究的目的是根据癫痫孕妇后代中不同先天性异常（CA）的减少情况，检验癫痫孕妇医疗护理进展的效果。首先，在匈牙利先天性异常病例对照监测系统（1980 - 1996年）中，比较了95名后来生育患有不同CA后代的孕妇（病例组）和90名后来分娩无CA新生儿的孕妇（对照组）的医学记录癫痫患病率。其次，比较了1980年至1989年和1990 - 1996年癫痫孕妇后代中不同CA的发生率。唇裂伴或不伴腭裂、腭裂、心血管CA、食管闭锁/狭窄、尿道下裂和多种CA在接受不同抗癫痫药物治疗的癫痫孕妇后代中显示出较高风险，主要原因是联合治疗。单药治疗后总CA风险没有升高。在研究的第二个阶段，癫痫孕妇后代的总CA发生率没有显著降低。基于癫痫孕妇后代中CA发生率的降低，未显示出癫痫孕妇特殊医疗护理的效果。
