Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine Unit, Meram Faculty of Medicine, Necmettin Erbakan University, Beysehir Street, No:281 Akyokus, 42080, Konya, Turkey.
Epilepsy Res. 2021 Mar;171:106566. doi: 10.1016/j.eplepsyres.2021.106566. Epub 2021 Jan 27.
There are inconsistent results in different studies on maternal and fetal complications of pregnant women with epilepsy (PWWE). The differences may be in part due to racial characteristics. The aim of this study was to investigate if there is an increase in obstetric and neonatal complications, especially postpartum hemorrhage, in pregnant women with epilepsy in the Turkish population.
In a tertiary center, PWWE and the control group were compared in terms of obstetric and neonatal complications as well as postpartum hemorrhage. Among 46,789 deliveries, 154 eligible PWWE were matched 1: 3 with the control group.
There was no increase in the possibility of peripartum hemorrhage and blood transfusion in PWWE. However, the probability of cesarean delivery was higher in PWWE (adjusted OR: 3.24 CI: 1.95-5.42, p < 0.001). Moreover, an increase in the possibility of fetal growth restriction, fetal death, admission to the neonatal intensive care unit and lower APGAR scores were found in PWWE.
Although the risk of peripartum hemorrhage does not appear to be increased in PWWE, cesarean rates and fetal complications do increase. There is also a need for prospective studies examining long-term neonatal outcomes in pregnancies complicated by epilepsy.
不同研究中关于孕妇癫痫(PWWE)的母婴并发症结果不一致。这些差异可能部分归因于种族特征。本研究旨在探讨土耳其人群中 PWWE 是否会增加产科和新生儿并发症,尤其是产后出血。
在一家三级中心,比较了 PWWE 和对照组的产科和新生儿并发症以及产后出血情况。在 46789 例分娩中,154 例符合条件的 PWWE 与对照组按 1:3 匹配。
PWWE 患者发生围产期出血和输血的可能性没有增加。然而,PWWE 行剖宫产的可能性更高(校正 OR:3.24,95%CI:1.95-5.42,p<0.001)。此外,PWWE 还存在胎儿生长受限、胎儿死亡、新生儿重症监护病房入院和较低的 APGAR 评分的可能性增加。
尽管 PWWE 患者围产期出血的风险似乎没有增加,但剖宫产率和胎儿并发症确实增加了。还需要前瞻性研究来检查癫痫合并妊娠的新生儿长期结局。