Department of Clinical Medicine, University of Bergen, Norway.
BJOG. 2011 Jul;118(8):956-65. doi: 10.1111/j.1471-0528.2011.03004.x. Epub 2011 May 11.
To report the complications during pregnancy and delivery in women with epilepsy, compared with a control group without epilepsy, with special focus on potential risk factors, such as epilepsy severity and dosage of antiepileptic drugs.
Hospital-based retrospective study.
Data from pregnancy notification forms and hospital case records.
Women with a past or present history of epilepsy (n = 205) delivered in Bergen, Norway, in the period 1999-2006, and a matched control group of women (n = 205) without epilepsy.
Data were compared and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated by multiple logistic regression models.
Pre-eclampsia (mild and severe), gestational hypertension, vaginal bleeding (early and late), caesarean section, vaginal operative delivery, postpartum haemorrhage and major malformations.
Women with epilepsy using antiepileptic drugs had an increased risk of severe pre-eclampsia (OR, 5.0; 95% CI, 1.3-19.9), bleeding in early pregnancy (OR, 6.4; 95% CI, 2.7-15.2), induction (OR, 2.3; 95% CI, 1.2-4.3) and caesarean section (OR, 2.5; 95% CI, 1.4-4.7) adjusted for maternal age, parity, education, smoking, medical conditions and body mass index ≥30 kg/m(2) . There was also an increased risk of malformations in the offspring (OR, 7.1; 95% CI, 1.4-36.6). Women without antiepileptic drug use had increased risks of forceps delivery and preterm birth. Active epilepsy (seizures during the last 5 years) versus nonactive epilepsy did not discriminate for any of these complications; 84.5% of women with epilepsy and antiepileptic drug use were using folate.
Women with epilepsy using antiepileptic drugs had an increased risk of pregnancy and delivery complications, whereas women not using antiepileptic drugs had few complications. Seizures, high doses of antiepileptic drugs, obesity and lack of folate could not explain these increased risks.
报告癫痫女性在妊娠和分娩期间的并发症，与无癫痫的对照组进行比较，特别关注潜在的危险因素，如癫痫严重程度和抗癫痫药物剂量。
基于医院的回顾性研究。
挪威卑尔根的妊娠通知表和医院病历数据。
1999 年至 2006 年间在挪威卑尔根分娩的有过去或现在癫痫病史的女性（n=205），以及一组匹配的无癫痫女性对照组（n=205）。
比较数据，并通过多因素逻辑回归模型计算比值比（OR）及其 95%置信区间（CI）。
子痫前期（轻度和重度）、妊娠高血压、阴道出血（早期和晚期）、剖宫产、阴道手术分娩、产后出血和主要畸形。
使用抗癫痫药物的癫痫女性发生重度子痫前期（OR，5.0；95%CI，1.3-19.9）、妊娠早期出血（OR，6.4；95%CI，2.7-15.2）、引产（OR，2.3；95%CI，1.2-4.3）和剖宫产（OR，2.5；95%CI，1.4-4.7）的风险增加，经产妇年龄、产次、教育程度、吸烟状况、合并症和 BMI≥30kg/m²校正后。后代畸形的风险也增加（OR，7.1；95%CI，1.4-36.6）。未使用抗癫痫药物的女性发生产钳分娩和早产的风险增加。活动性癫痫（过去 5 年内发作）与非活动性癫痫对这些并发症均无明显区分；84.5%使用抗癫痫药物的癫痫女性正在服用叶酸。
使用抗癫痫药物的癫痫女性妊娠和分娩并发症风险增加，而未使用抗癫痫药物的女性并发症较少。癫痫发作、高剂量抗癫痫药物、肥胖和缺乏叶酸不能解释这些增加的风险。
