Alsfouk Bshra A, Almarzouqi Manal Rashed, Alageel Saleh, Alsfouk Aisha A, Alsemari Abdulaziz
Department of Pharmaceutical Sciences, College of Pharmacy, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia.
Biostatistics, Epidemiology & Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
Saudi Pharm J. 2022 Mar;30(3):205-211. doi: 10.1016/j.jsps.2021.12.006. Epub 2022 Jan 4.
To evaluate patterns of antiseizure medication (ASM) prescription in pregnancy and changes over a 16-year period: 2005-2020, and to investigate maternal complications in pregnant women with epilepsy (WWE).
Data of pregnant WWE was retrospectively reviewed at the King Faisal Specialist Hospital and Research Centre, Riyadh and Jeddah, Saudi Arabia.
Out of 162 pregnancies, 81.5% were prescribed ASMs. During the study period, the prescription rate increased from 68.8% to 93.5%. Between 2005 and 2020, the use of new ASMs increased from 15.4% to 75.5% (p < 0.0001). Furthermore, valproate use markedly decreased from 23.08% to 2.04%. The rate of maternal and delivery complications was 29.6%; the most frequent was gestational diabetes (5.6%), followed by bleeding during pregnancy (4.9%). Furthermore, preeclampsia and eclampsia were documented in 3.7% and 1.8%, respectively. ASMs use and other factors were not found to be associated with maternal complications (p > 0.05). However, first generation ASMs, i.e. carbamazepine (38.71%) and valproate (41.67%), were associated with higher maternal complication rates than new ASMs, i.e. levetiracetam (25%) and lamotrigine (20%), but the difference was not statistically significant (p = 0.4403).
ASM prescription in pregnancy is increasing as is the use of new ASMs. The rate of maternal and delivery complications was relatively low, particularly preeclampsia and eclampsia. ASMs use was not found to associated with these complications. However, exposure to first generation ASMs seemed to be a predictor of adverse pregnancy outcomes.
评估2005年至2020年这16年间孕期抗癫痫药物（ASM）的处方模式及其变化，并调查癫痫孕妇（WWE）的母体并发症。
回顾性分析沙特阿拉伯利雅得和吉达法赫德国王专科医院及研究中心的癫痫孕妇数据。
在162例妊娠中，81.5%的孕妇开具了ASM。在研究期间，处方率从68.8%升至93.5%。2005年至2020年，新型ASM的使用从15.4%增至75.5%（p<0.0001）。此外，丙戊酸盐的使用从23.08%显著降至2.04%。母体及分娩并发症发生率为29.6%；最常见的是妊娠期糖尿病（5.6%），其次是孕期出血（4.9%）。此外，子痫前期和子痫的记录发生率分别为3.7%和1.8%。未发现ASM的使用及其他因素与母体并发症相关（p>0.05）。然而，第一代ASM，即卡马西平（38.71%）和丙戊酸盐（41.67%），与新型ASM，即左乙拉西坦（25%）和拉莫三嗪（20%）相比，母体并发症发生率更高，但差异无统计学意义（p=0.4403）。
孕期ASM处方及新型ASM的使用均在增加。母体及分娩并发症发生率相对较低，尤其是子痫前期和子痫。未发现ASM的使用与这些并发症相关。然而，接触第一代ASM似乎是不良妊娠结局的一个预测因素。
