Alanazy Mohammed H, Asiri Alanood, Edrees Maha F, Abuzinadah Ahmad R
Department of Internal Medicine, College of Medicine, King Saud University.
Department of Physical Medicine and Rehabilitation, King Fahad Medical City, Riyadh.
Medicine (Baltimore). 2020 Oct 30;99(44):e22978. doi: 10.1097/MD.0000000000022978.
This cross-sectional study aimed to assess the impact of epilepsy, myasthenia gravis (MG), and multiple sclerosis (MS) on pregnancy and family planning decision-making in a cohort of Saudi women. Women with epilepsy, MG, and MS were recruited consecutively at the time of their follow-up visits at a neurology clinic. Data were collected using 3 standardized questionnaires, and presented using descriptive statistics. A logistic regression was performed to determine variables associated with decisions regarding abstaining from pregnancy and encouraging other women to conceive. A total of 272 (83 epilepsy, 69 MG, and 120 MS) women with a mean age of 29.9 ± 8.0 years participated. The proportion of women who abstained from or postponed pregnancy was 41.2% and 31.4%, respectively. The concerns mentioned most often were disease worsening during pregnancy, peripartum and postpartum, side effects of medications on the unborn child, and inability to care for the child. Older age was independently associated with the decision to abstain from pregnancy (odds ratio [OR] 1.14, 95% confidence interval [CI] 1.04 - 1.25). Higher knowledge levels were independently associated with encouraging other women to have children (OR 1.3, 95% CI 1.11-1.53). Over 50% of women reported that they were not counseled on issues related to pregnancy and childbirth. In conclusion, we identified a major influence of epilepsy, MG, and MS on pregnancy and family planning. Comprehensive counseling programs are needed to help women with these neurological diseases make informed family-planning decisions.
这项横断面研究旨在评估癫痫、重症肌无力（MG）和多发性硬化症（MS）对一组沙特女性妊娠及计划生育决策的影响。患有癫痫、MG和MS的女性在神经内科诊所进行随访时被连续招募。使用3份标准化问卷收集数据，并采用描述性统计进行呈现。进行逻辑回归分析以确定与避免怀孕及鼓励其他女性怀孕的决策相关的变量。共有272名女性参与，平均年龄为29.9±8.0岁（癫痫患者83名、MG患者69名、MS患者120名）。避免怀孕或推迟怀孕的女性比例分别为41.2%和31.4%。最常提及的担忧是孕期、围产期和产后疾病恶化、药物对未出生胎儿的副作用以及无力照顾孩子。年龄较大与避免怀孕的决策独立相关（优势比[OR]为1.14，95%置信区间[CI]为1.04 - 1.25）。知识水平较高与鼓励其他女性生育独立相关（OR为1.3，95%CI为1.11 - 1.53）。超过50%的女性报告称她们未接受过与妊娠和分娩相关问题的咨询。总之，我们确定癫痫、MG和MS对妊娠及计划生育有重大影响。需要全面的咨询项目来帮助患有这些神经系统疾病的女性做出明智的计划生育决策。
