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患有癫痫的女性的孕产妇死亡:范围较小的研究。

Maternal death in women with epilepsy: Smaller scope studies.

机构信息

From the Department of Neurology (J.C.), Aarhus University Hospital; and Research Unit for General Practice (C.V.), Department of Public Health, and Section for Epidemiology (B.H.B.), Department of Public Health, Aarhus University, Denmark.

出版信息

Neurology. 2018 Oct 30;91(18):e1716-e1720. doi: 10.1212/WNL.0000000000006426. Epub 2018 Sep 26.

Abstract

OBJECTIVE

To determine the maternal mortality in women with epilepsy.

METHODS

This was a matched case-control study of pregnant women in Denmark who were born in Denmark between January 1, 1962, and December 31, 1994, and who were alive on their 18th birthday. We defined maternal mortality as deaths in pregnancy and the first 42 days after termination of pregnancy. Cases were pregnancies in women with a diagnosis of epilepsy before the termination of pregnancy. Data were analyzed with a conditional logistic model. For comparison, we estimated the mortality in women of childbearing age (18-50 years) diagnosed with epilepsy regardless of pregnancy status using a Poisson model.

RESULTS

We identified 2,105,084 pregnancies, including 11,976 (0.57%) pregnancies in which the mother was diagnosed with epilepsy. Of the 176 maternal deaths in this cohort, 5 women had a diagnosis of epilepsy. The mortality associated with an epilepsy diagnosis was >5 times higher compared to the mortality in women without this diagnosis (odds ratio 5.57, 95% confidence interval 2.23-13.9, < 0.001).

CONCLUSIONS AND RELEVANCE

Maternal mortality in women with epilepsy in Denmark was lower than what has previously been reported from United States and the United Kingdom. However, the maternal mortality in women with epilepsy was considerably higher compared to women without epilepsy. Further studies should address whether improving epilepsy care in women with epilepsy could reduce the rate of maternal deaths.

摘要

目的

确定癫痫女性的孕产妇死亡率。

方法

这是一项在丹麦进行的匹配病例对照研究,研究对象为 1962 年 1 月 1 日至 1994 年 12 月 31 日期间在丹麦出生且在 18 岁生日时仍存活的孕妇。我们将孕产妇死亡定义为妊娠期间和终止妊娠后 42 天内的死亡。病例为终止妊娠前被诊断为癫痫的孕妇的妊娠。采用条件逻辑回归模型进行数据分析。为了进行比较,我们使用泊松模型估计了无论妊娠状态如何被诊断患有癫痫的育龄妇女(18-50 岁)的死亡率。

结果

我们确定了 2105084 例妊娠,其中 11976 例(0.57%)孕妇被诊断为癫痫。在该队列中,有 176 例产妇死亡,其中 5 例患有癫痫。与未被诊断患有癫痫的产妇相比,患有癫痫的产妇的死亡率高出 5 倍以上(比值比 5.57,95%置信区间 2.23-13.9, < 0.001)。

结论和相关性

丹麦癫痫女性的孕产妇死亡率低于美国和英国此前的报告。然而,与无癫痫的女性相比,癫痫女性的孕产妇死亡率仍然高得多。进一步的研究应探讨是否改善癫痫女性的癫痫护理可以降低孕产妇死亡率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b88c/6207413/dd20b15ae9a8/NEUROLOGY2018877357FF1.jpg

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