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抗癫痫药物对孕早期筛查试验结果的影响。

Effect of anti-epileptic drugs on first trimester screening test results.

作者信息

Unal Canan, Tanacan Atakan, Fadiloglu Erdem, Portakal Oytun, Beksac M Sinan

机构信息

Division of Perinatology, Department of Obstetric and Gynecology, Ankara, Turkey.

Division of Perinatology, Department of Obstetric and Gynecology, Ankara, Turkey.

出版信息

Taiwan J Obstet Gynecol. 2020 Nov;59(6):835-837. doi: 10.1016/j.tjog.2020.09.009.

Abstract

OBJECTIVE

To evaluate first trimester screening test parameters in epileptic patients using anti-epileptic drugs.

MATERIALS AND METHODS

We retrospectively evaluated first trimester screening test results of 23 epileptic pregnant women using anti-epileptic drugs with a control group consisting of 92 healthy pregnancies. The anti-epileptic drugs used in this study were carbamazepine, levatiracetam, valproic acid and lamotrigine. Single drug or multi-drug regimens were used according to the clinical conditions. Patients with any known chronic or acute disease and drug usage were excluded from the study. Comparisons were performed via Mann-Whitney U test.

RESULTS

First trimester screening test biochemical markers were compared and maternal serum PAPP-A MoM values were found to be similar in study and control groups while β-hCG MoM values were significantly higher in pregnancies using epileptic drugs (p: 0,737 and p < 0.001, respectively).

CONCLUSION

Biochemical first trimester screening test results may be affected by anti-epileptic drug usage, which may lead to misinterpretation of the risk level. Thus, validation of MoM values should be necessary in order to obtain optimal results.

摘要

目的

评估使用抗癫痫药物的癫痫患者孕早期筛查试验参数。

材料与方法

我们回顾性评估了23名使用抗癫痫药物的癫痫孕妇的孕早期筛查试验结果,并与92例正常妊娠的对照组进行比较。本研究中使用的抗癫痫药物有卡马西平、左乙拉西坦、丙戊酸和拉莫三嗪。根据临床情况使用单药或多药治疗方案。研究排除了任何已知患有慢性或急性疾病以及正在使用药物的患者。通过Mann-Whitney U检验进行比较。

结果

对孕早期筛查试验的生化标志物进行了比较,发现研究组和对照组孕妇血清妊娠相关血浆蛋白A(PAPP-A)的中位数倍数(MoM)值相似,而使用抗癫痫药物的孕妇β-人绒毛膜促性腺激素(β-hCG)的MoM值显著更高(分别为p: 0.737和p < 0.001)。

结论

孕早期生化筛查试验结果可能受抗癫痫药物使用的影响,这可能导致对风险水平的错误解读。因此,为了获得最佳结果,有必要对MoM值进行验证。

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