Departments of Medicine and Neurosciences, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia.
Department of Neuroscience, Monash University, Melbourne, Victoria, Australia.
Acta Neurol Scand. 2022 Nov;146(5):610-614. doi: 10.1111/ane.13688. Epub 2022 Aug 19.
To investigate control of epileptic seizures during pairs of successive pregnancies in antiseizure medication (ASM)-treated women with epilepsy.
Analysis of seizure freedom rates during 436 pairs of successive pregnancies in Australian women with epilepsy, in nearly all instances long-standing epilepsy.
There was a higher rate of seizure-free second pregnancies compared with first paired pregnancies (63.1% vs. 51.4%; Relative Risk (R.R.) = 1.2277; 95% CI 1.0930, 1.3789) and of seizure-free pre-pregnancy years before second as compared with first paired pregnancies in the same women (63.6% vs. 52.4%; R.R. = 1.2616; 95% CI 1.1337, 1.4040). In 108 women whose ASM therapy was unaltered throughout both of their pregnancies, the seizure-freedom rate was higher in the second of the paired pregnancies (82.4% vs. 69.4%; R.R. = 1.1867, 95% CI 1.0189, 1.3821).
Altered ASM therapy after the first of a pair of successive pregnancies did not fully account for the better overall seizure control in the corresponding second pregnancies. Some additional factor may have been in operation, possibly a greater preparedness to undertake a further pregnancy if seizures were already fully controlled.
研究抗癫痫药物（ASM）治疗的癫痫女性连续两次妊娠期间癫痫发作的控制情况。
对澳大利亚癫痫女性的 436 对连续妊娠进行了无癫痫发作率的分析，这些女性几乎都患有长期癫痫。
与第一次配对妊娠相比，第二次无癫痫发作的妊娠率更高（63.1%对 51.4%；相对风险（RR）=1.2277；95%置信区间 1.0930，1.3789），与同一女性第一次配对妊娠相比，第二次无癫痫发作的妊娠前年份也更高（63.6%对 52.4%；RR=1.2616；95%置信区间 1.1337，1.4040）。在 108 名女性中，她们的 ASM 治疗在两次妊娠期间均未改变，第二次妊娠的无癫痫发作率更高（82.4%对 69.4%；RR=1.1867，95%置信区间 1.0189，1.3821）。
第一次连续妊娠后改变 ASM 治疗并不能完全解释相应第二次妊娠中总体更好的癫痫控制。可能有一些额外的因素在起作用，如果癫痫已经完全得到控制，可能会有更大的准备再次怀孕。
