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猝倒性睡眠发作伴发的发作性睡病与妊娠:病例对照研究。

Narcolepsy with cataplexy and pregnancy: a case-control study.

机构信息

Sleep and Epilepsy Unit - Clinical Neurophysiology Service, University General Hospital Gregorio Maranon, University Complutense of Madrid (UCM), Madrid, Spain.

出版信息

J Sleep Res. 2018 Apr;27(2):268-272. doi: 10.1111/jsr.12567. Epub 2017 Jun 1.

Abstract

This was a retrospective case-control study in 25 patients with narcolepsy with cataplexy and 75 women in the control group. Patients completed the questionnaire by Maurovich-Horvat et al. (J. Sleep Res., 2013, 22: 496-512). We personally interviewed 25 patients with narcolepsy with cataplexy using the administered questionnaire regarding conception, pregnancy, delivery, perinatal and breastfeeding periods. Patients with narcolepsy with cataplexy reported 59 pregnancies versus 164 in the control group. In 16 cases (27.1%), a disease before pregnancy was present compared with eight cases (4.9%) in the control group (P < 0.001); among them, extrinsic asthma was reported 11 times in the narcolepsy with cataplexy group (P < 0.005). Patients with narcolepsy with cataplexy more often had a single pregnancy compared with controls (P < 0.05). Gestational diabetes was more frequent in patients with narcolepsy with cataplexy (P < 0.05). Induced deliveries were higher in controls (P < 0.009). No differences were found between the groups in terms of duration of pregnancies and complications during and after delivery, as during the puerperium. Neonates from patients had heavier birth weight (P < 0.015). The breastfeeding period was longer in patients (P < 0.01). Modafinil and methylphenidate were the drugs administered in six pregnancies. No significant differences in depression during pregnancy and during puerperium were found between patients and controls. This is the first case-control study in women with narcolepsy with cataplexy related to pregnancy, delivery, childbirth and puerperium. Data suggest that patients have pregnancy outcomes similar to controls. The prevalence of gestational diabetes was higher in women with narcolepsy with cataplexy. Caesarean sections, complications during delivery and normal perinatal period for infants were similar in both groups. Breastfeeding was longer in patients.

摘要

这是一项针对 25 例猝倒性发作的发作性睡病患者和 75 名对照组女性的回顾性病例对照研究。患者使用 Maurovich-Horvat 等人的问卷完成了问卷(J. Sleep Res.,2013,22:496-512)。我们使用 administered 问卷亲自采访了 25 例猝倒性发作的发作性睡病患者,询问了他们的妊娠、分娩、围产期和哺乳期情况。猝倒性发作的发作性睡病患者报告了 59 次妊娠,而对照组为 164 次。在 16 例(27.1%)患者中,存在妊娠前疾病,而对照组为 8 例(4.9%)(P<0.001);其中,发作性睡病伴猝倒组报告了 11 例外源性哮喘(P<0.005)。猝倒性发作的发作性睡病患者的单胎妊娠比例高于对照组(P<0.05)。发作性睡病伴猝倒组妊娠期糖尿病更为常见(P<0.05)。对照组引产率较高(P<0.009)。两组在妊娠期间和分娩后期间和期间的并发症、产褥期方面无差异。来自患者的新生儿出生体重较重(P<0.015)。患者的母乳喂养期较长(P<0.01)。六例妊娠中使用了莫达非尼和哌甲酯。未发现患者和对照组在妊娠和产褥期期间抑郁程度存在显著差异。这是首例与妊娠、分娩、分娩和产褥期相关的猝倒性发作的发作性睡病女性病例对照研究。数据表明,患者的妊娠结局与对照组相似。猝倒性发作的发作性睡病患者妊娠期糖尿病的患病率较高。两组剖宫产、分娩并发症和正常围产期婴儿情况相似。患者的母乳喂养时间较长。

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