Olafsson E, Hallgrimsson J T, Hauser W A, Ludvigsson P, Gudmundsson G
Department of Neurology, National University Hospital, Reykjavik, Iceland.
Epilepsia. 1998 Aug;39(8):887-92. doi: 10.1111/j.1528-1157.1998.tb01186.x.
Women with epilepsy who become pregnant are commonly considered to be at high risk for complications during pregnancy or delivery. The offspring are also considered to have increased risk of perinatal mortality, congenital malformations, and maturational delay. Because few of these studies are population based, potential bias exists because of selection.
We performed a historical population-based cohort study in Iceland to determine the prevalence of epilepsy among pregnant women, to identify pregnancy and delivery complications in women with epilepsy, and to determine the outcome of their pregnancies as compared with that in the general population of Iceland. We identified all women with active epilepsy who gave birth during a 19-year period in Iceland.
In this population, 3.3 in 1,000 pregnancies involve mothers with active epilepsy. The frequency of adverse events (AE) during pregnancy in the women with epilepsy is similar to that observed among all live births in the population, but cesarean section was performed twice as frequently as in the general population. Perinatal mortality rate and mean birth weight are not significantly different in the offspring of women with epilepsy as compared with rest of the population. The risk of major congenital malformations (MGM) is increased 2.7-fold over that expected when a mother is treated with antiepileptic drugs (AEDs) during a pregnancy.
Our study indicates that the rate of complications of pregnancy in mothers with active epilepsy is low and similar to that of the general population with epilepsy. Use of AEDs by the mother during pregnancy significantly increases the risk of MGM in the offspring.
癫痫女性怀孕通常被认为在妊娠或分娩期间发生并发症的风险很高。其后代也被认为围产期死亡率、先天性畸形和发育迟缓的风险增加。由于这些研究很少基于人群，因此存在因选择而导致的潜在偏倚。
我们在冰岛进行了一项基于历史人群的队列研究，以确定孕妇中癫痫的患病率，确定癫痫女性的妊娠和分娩并发症，并将她们的妊娠结局与冰岛普通人群进行比较。我们确定了冰岛19年间所有患有活动性癫痫并分娩的女性。
在该人群中，每1000次妊娠中有3.3次涉及患有活动性癫痫的母亲。癫痫女性妊娠期间不良事件（AE）的发生率与该人群所有活产中观察到的发生率相似，但剖宫产的实施频率是普通人群的两倍。与其他人群相比，癫痫女性后代的围产期死亡率和平均出生体重无显著差异。当母亲在孕期使用抗癫痫药物（AEDs）时，主要先天性畸形（MGM）的风险比预期增加2.7倍。
我们的研究表明，患有活动性癫痫的母亲妊娠并发症发生率较低，与普通癫痫人群相似。母亲在孕期使用AEDs会显著增加后代患MGM的风险。
