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癫痫男性患者的精神共病、性健康和后代神经发育结局。

Psychiatric comorbidities, sexual health and neurodevelopmental outcomes of offspring in men with epilepsy.

机构信息

Icahn School of Medicine at Mount Sinai, School of Medicine, 1 Gustave L. Levy Place, New York, NY 10029, United States.

Icahn School of Medicine at Mount Sinai Downtown, Department of Neurology, 10 Union Square East, Suite 5D, New York, NY 10003, United States.

出版信息

Epilepsy Behav. 2021 Jan;114(Pt A):107562. doi: 10.1016/j.yebeh.2020.107562. Epub 2020 Nov 24.

Abstract

BACKGROUND

There is a paucity of data in the literature specific to men with epilepsy on anti-seizure medication (ASM). The current study investigated the time to conception as well as the gestational and the neurodevelopmental outcomes of offspring of men with epilepsy on ASM compared to controls. Additionally, the prevalence of psychiatric comorbidities, and measures of sexual performance in males with and without epilepsy were analyzed.

METHODS

A total of 450 male patients with and without epilepsy at one hospital were provided questionnaires to determine demographic characteristics, epilepsy history, type of ASM at the time of conception, comorbidities and sexual health. Time to conception, fertility methods and offspring birth and developmental history born to males with and without epilepsy was recorded. Survey data was evaluated using Student's t-test for continuous variables and Fisher's exact test for categorical variables. Odds ratio (OR) were calculated to determine associations between the measured data.

RESULTS

After matching for age, we analyzed a total of 110 males with epilepsy and 110 without epilepsy. In the epilepsy group there was a higher rate of psychiatric comorbidities such as major depressive disorder, general anxiety disorder, bipolar disorder, and suicidal ideation when compared to the control group (N = 110; OR 3.39; 95% IC: 1.87-6.13, p < 0.001). Males with epilepsy also had a higher frequency of low erection scores when compared to males without epilepsy (N = 70 with epilepsy, N = 76 without epilepsy; OR 3.67; 95% IC: 1.44-9.39, p = 0.005). Of the 110 men with a diagnosis of epilepsy, 17 conceived children while using ASMs (38 total children). A total of 18.42% of children born to fathers on ASMs experienced developmental delays compared to 2.63% of controls, however this result was not statistically significant (p = 0.056). In addition, we did not find that offspring had significantly different birth weights or gestational ages in men on ASM compared to controls (p > 0.05).

CONCLUSIONS

The present study suggests that men with epilepsy have an increased incidence of psychiatric comorbidities, and altered sexual performance, specifically erectile dysfunction, when compared with men without epilepsy. There was no statistically significant difference in the rates of developmental disorders and birth characteristics among those men with epilepsy on ASM at the time of conception and controls.

摘要

背景

针对服用抗癫痫药物(ASM)的男性癫痫患者,文献中相关数据稀缺。本研究调查了服用 ASM 的男性癫痫患者与对照组相比,其受孕时间、后代的妊娠和神经发育结局。此外,还分析了男性癫痫患者和非癫痫患者的精神共病患病率以及性功能指标。

方法

一家医院的 450 名男性癫痫患者和非癫痫患者收到了问卷,以确定人口统计学特征、癫痫病史、受孕时 ASM 的类型、合并症和性健康。记录了男性癫痫患者和非癫痫患者的受孕时间、生育方法以及后代的出生和发育史。使用学生 t 检验评估连续变量的数据,使用 Fisher 精确检验评估分类变量的数据。计算比值比(OR)以确定测量数据之间的关联。

结果

在年龄匹配后,我们共分析了 110 名癫痫男性和 110 名非癫痫男性。与对照组相比,癫痫组的精神共病患病率更高,如重度抑郁障碍、广泛性焦虑障碍、双相情感障碍和自杀意念(N=110;OR 3.39;95%CI:1.87-6.13,p<0.001)。与非癫痫男性相比,癫痫男性勃起评分较低的频率更高(N=70 名癫痫男性,N=76 名非癫痫男性;OR 3.67;95%CI:1.44-9.39,p=0.005)。在 110 名被诊断为癫痫的男性中,有 17 名在服用 ASM 时怀孕(共 38 名儿童)。与对照组相比,在服用 ASM 的父亲所生的孩子中,有 18.42%经历了发育迟缓,然而这一结果并无统计学意义(p=0.056)。此外,我们并未发现男性癫痫患者受孕时服用 ASM 与对照组相比,后代的出生体重或胎龄有显著差异(p>0.05)。

结论

本研究表明,与非癫痫男性相比,癫痫男性的精神共病发病率更高,性功能更差,特别是勃起功能障碍。在受孕时服用 ASM 的癫痫男性与对照组相比,发育障碍和出生特征的发生率没有统计学差异。

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