Department of Neurology and Neurosurgery, University of Tartu, Estonia; Neurology Clinic, Tartu University Hospital, Tartu, Estonia.
Estonian State Agency of Medicines, Tartu, Estonia.
Epilepsy Behav. 2021 Dec;125:108404. doi: 10.1016/j.yebeh.2021.108404. Epub 2021 Nov 11.
For many women with epilepsy (WWE), decision making about pregnancy is difficult, due mainly to the potential teratogenic risks of anti-seizure medications (ASMs). Pre-pregnancy counseling is essential to minimize these risks. This study was conducted to assess the rate and effectiveness of pre-pregnancy counseling for women treated with valproate (VPA) in Estonia.
We used outpatient prescription data from the national health insurance provider to identify all women treated with VPA during 2011-2018 in Estonia. The personal medical documentation of women who became pregnant while on VPA treatment was reviewed. Pre-pregnancy counseling history and VPA-treatment indications were analyzed.
Data from 141 women who became pregnant while on VPA treatment during 2011-2018 time period were analyzed. Of these patients, 77% had epilepsy and 19% psychiatric diagnoses. Pre-pregnancy counseling was recorded for 13% (n = 19) of women who later became pregnant. VPA monotherapy and the lack of VPA treatment indication were associated with the lack of counseling before pregnancy.
This study revealed a significant deficit in pre-pregnancy counseling for WWE treated with VPA in Estonia. Awareness of the need for such counseling should be increased among medical specialists.
对于许多患有癫痫的女性（WWE）来说，关于怀孕的决策是困难的，主要是因为抗癫痫药物（ASMs）有潜在的致畸风险。孕前咨询对于最大限度地降低这些风险至关重要。本研究旨在评估在爱沙尼亚接受丙戊酸钠（VPA）治疗的女性接受孕前咨询的比率和效果。
我们使用国家健康保险公司的门诊处方数据，确定了 2011-2018 年期间在爱沙尼亚接受 VPA 治疗的所有女性。审查了在 VPA 治疗期间怀孕的女性的个人医疗记录。分析了孕前咨询史和 VPA 治疗指征。
分析了 2011-2018 年期间在 VPA 治疗期间怀孕的 141 名女性的数据。这些患者中，77%患有癫痫，19%患有精神科诊断。在后来怀孕的女性中，有 13%（n=19）记录了孕前咨询。VPA 单药治疗和缺乏 VPA 治疗指征与怀孕前缺乏咨询有关。
本研究揭示了在爱沙尼亚，接受 VPA 治疗的 WWE 女性在孕前咨询方面存在显著不足。应提高医疗专家对这种咨询需求的认识。
