孕期癫痫与饮食失调：患病率、并发症及分娩结局

Epilepsy and eating disorders during pregnancy: Prevalence, complications and birth outcome.

作者信息

Kolstad Eivind, Gilhus Nils Erik, Veiby Gyri, Reiter Simone Frizell, Lossius Morten Ingvar, Bjørk Marte

机构信息

Department of Clinical Medicine, University of Bergen, Bergen, Norway; Department of Neurology, Haukeland University Hospital, Bergen, Norway.

出版信息

Seizure. 2015 May;28:81-4. doi: 10.1016/j.seizure.2015.02.014. Epub 2015 Feb 21.

DOI:10.1016/j.seizure.2015.02.014

PMID:25794467

Abstract

PURPOSE

The aim was to investigate the prevalence of eating disorders and its relation to pregnancy and delivery complications in childbearing women with epilepsy (WWE).

METHOD

This study is based on The Norwegian Mother and Child Cohort Study (MoBa) linked to the Medical Birth Registry of Norway. Epilepsy was reported in 706 pregnancies. The remaining cohort (n=106,511) served as the reference group. Eating disorders were diagnosed using DSM-IV criteria adjusted for pregnancy. The risk of preeclampsia, gestational hypertension, diabetes and weight gain during pregnancy as well as delivery outcome (small for gestational age, large for gestational age, ponderal index, low APGAR score, small head circumference) were calculated as odds ratios (ORs) with 95% confidence intervals (CIs) adjusted for maternal age, smoking, parity and socioeconomic factors.

RESULTS

Pregnant WWE were significantly more likely to have binge eating disorder (6.5% vs. 4.7%, p<0.05). WWE and comorbid eating disorders had significantly more preeclampsia (7.9% vs. 3.7%, p<0.05), peripartum depression and/or anxiety (40.4% vs. 17.8%, p<0.001) and operative delivery (38.2% vs. 23.5%, p<0.001) than the reference group without epilepsy or eating disorders. After adjustment for confounders, a significantly increased risk of operative delivery (OR 1.96, CI 1.26-3.05) and peripartum depression and/or anxiety (OR 2.17, CI 1.40-3.36) was demonstrated.

CONCLUSION

Eating disorders in WWE contribute to the increased risk of pregnancy and delivery complications. Health personnel should be aware of eating disorders in WWE and refer them for treatment before pregnancy.

摘要

目的

旨在调查癫痫育龄妇女（WWE）饮食失调的患病率及其与妊娠和分娩并发症的关系。

方法

本研究基于与挪威医疗出生登记处相关联的挪威母婴队列研究（MoBa）。706例妊娠报告有癫痫。其余队列（n = 106,511）作为参照组。饮食失调采用针对妊娠调整的《精神疾病诊断与统计手册》第四版（DSM-IV）标准进行诊断。计算先兆子痫、妊娠高血压、糖尿病和孕期体重增加以及分娩结局（小于胎龄、大于胎龄、 ponderal指数、低阿氏评分、小头围）的风险，以比值比（OR）及95%置信区间（CI）表示，并对产妇年龄、吸烟、产次和社会经济因素进行校正。

结果

妊娠WWE发生暴饮暴食症的可能性显著更高（6.5%对4.7%，p<0.05）。与无癫痫或饮食失调的参照组相比，WWE及合并饮食失调者发生先兆子痫（7.9%对3.7%，p<0.05）、围产期抑郁和/或焦虑（40.4%对17.8%，p<0.001）以及手术分娩（38.2%对23.5%，p<0.001）的情况显著更多。校正混杂因素后，显示手术分娩（OR 1.96，CI 1.26 - 3.05）和围产期抑郁和/或焦虑（OR 2.17，CI 1.40 - 3.36）的风险显著增加。