Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
Department of Industrial Engineering, Tsinghua University, Beijing 100084, China.
Med. 2024 Oct 11;5(10):1326-1333.e4. doi: 10.1016/j.medj.2024.07.005. Epub 2024 Jul 24.
Most pregnant women with epilepsy do not receive proper medical care, which creates a special burden worldwide. We aimed to qualify this special global burden and assess the impact of different clinical management strategies to reduce it.
The data used in this study were extracted from articles published between 2005 and 2022. We calculated the economic costs associated with major burdens experienced by pregnant women with epilepsy. We developed a microsimulation model to estimate the different effects of various interventions and their combinations as integrated strategies for pregnant women with epilepsy and related burden reduction. We also compared the regional differences in disease burden and interventions.
The total economic burden for pregnant women with epilepsy is estimated to reach $1.8 billion globally annually, which is more than three times the burden for epilepsy alone. Folic acid supplementation is projected to be the most effective intervention, with a 9.1% reduction in major congenital malformations, a 14.9% reduction in autism spectrum disorder, and a 10.8% reduction in offspring-related economic burden globally annually. Integrated strategies are associated with a reduced economic burden of up to $37.7 million annually globally. Folic acid supplementation is the most effective intervention in high- and upper-middle-income countries, whereas changes in antiseizure medication prescriptions are more effective in lower-middle- and low-income countries.
This study highlights the huge burden for pregnant women with epilepsy and actions that must be taken to improve their quality of life.
This work was supported by the Sichuan Science and Technology Program (2023YFS0047).
大多数患有癫痫的孕妇得不到适当的医疗护理，这在全球范围内造成了特殊负担。我们旨在确定这种特殊的全球负担，并评估不同临床管理策略的影响，以减轻这种负担。
本研究使用的数据来自于 2005 年至 2022 年期间发表的文章。我们计算了与患有癫痫的孕妇所经历的主要负担相关的经济成本。我们开发了一个微观模拟模型，以评估各种干预措施及其组合作为综合策略对患有癫痫的孕妇及其相关负担减轻的不同影响。我们还比较了疾病负担和干预措施的区域差异。
患有癫痫的孕妇的总经济负担估计每年在全球达到 18 亿美元，是癫痫本身负担的三倍多。叶酸补充剂被预计是最有效的干预措施，可将主要先天畸形减少 9.1%，自闭症谱系障碍减少 14.9%，全球每年与后代相关的经济负担减少 10.8%。综合策略与每年全球减少高达 3770 万美元的经济负担有关。叶酸补充剂在高收入和上中等收入国家是最有效的干预措施，而改变抗癫痫药物处方在中低收入和低收入国家更为有效。
本研究强调了患有癫痫的孕妇的巨大负担，以及必须采取行动改善她们的生活质量。
这项工作得到了四川省科技计划（2023YFS0047）的支持。
