Sabers A, aRogvi-Hansen B, Dam M, Fischer-Rasmussen W, Gram L, Hansen M, Møller A, Winkel H
University Clinic of Neurology, University of Copenhagen, Denmark.
Acta Neurol Scand. 1998 Mar;97(3):164-70. doi: 10.1111/j.1600-0404.1998.tb00631.x.
We studied the course of pregnancy in women with epilepsy to identify possible risk factors which might complicate the epilepsies and pregnancy outcomes.
Data were collected retrospectively from the records of 151 pregnancies in 124 women with epilepsy from 1978-1992. Epilepsy variables were compared with that of non-pregnant women with epilepsy matched for age. Obstetric and neonatal variables were compared with those of all deliveries in the same unit from 1979-1992 (n=38,983).
Pregnancy among patients with epilepsy was more likely to occur in women with relatively mild epilepsy. In 12% of the pregnancies, the women were untreated while 71% were on monotherapy. Twenty-one percent had increased seizure frequency during the pregnancy. Perinatal deaths among newborns of epileptic mothers (1.3%) was more frequent but not significantly increased compared to the background population of 0.5% (95% CI 0.2-4.7). A total of 5.3% had congenital malformations compared to 1.5% in the controls (95% CI 2.3-10.3). No neural tube defects were observed. Maternal treatment with phenytoin was significantly related to the occurrence of congenital malformations, P=0.04.
Most women with epilepsy have an uncomplicated pregnancy and normal healthy offsprings. Maternal treatment with phenytoin might be associated with congenital malformations. No other risk factors could be identified.
我们研究了癫痫女性的妊娠过程，以确定可能使癫痫和妊娠结局复杂化的潜在危险因素。
回顾性收集了1978年至1992年间124例癫痫女性的151次妊娠记录。将癫痫变量与年龄匹配的非妊娠癫痫女性进行比较。将产科和新生儿变量与1979年至1992年同一科室的所有分娩情况（n = 38,983）进行比较。
癫痫患者的妊娠更可能发生在癫痫病情相对较轻的女性中。在12%的妊娠中，女性未接受治疗，而71%接受单一疗法。21%的女性在孕期癫痫发作频率增加。癫痫母亲所生新生儿的围产期死亡率（1.3%）高于背景人群的0.5%，但差异无统计学意义（95%可信区间0.2 - 4.7）。共有5.3%的新生儿有先天性畸形，而对照组为1.5%（95%可信区间2.3 - 10.3）。未观察到神经管缺陷。母亲使用苯妥英治疗与先天性畸形的发生显著相关，P = 0.04。
大多数癫痫女性妊娠过程顺利，后代健康正常。母亲使用苯妥英治疗可能与先天性畸形有关。未发现其他危险因素。
