Abstract：
BACKGROUND: Epilepsy is a disease that affects a significant proportion of the female population worldwide. The management of anti-seizure medications during pregnancy and the potential adverse outcomes to both the mother and fetus represent a significant challenge. This retrospective study aimed to evaluate the impact of anti-seizure medications during pregnancy by comparing maternal and fetal outcomes between pregnant women with and without epilepsy.
METHODS: A total of 242 participants were analysed, including 112 with epilepsy and 130 healthy pregnant controls. Maternal age, medical history, seizure characteristics, use of anti-seizure medications, and pregnancy history were recorded. Maternal and fetal complications, delivery modes, and perinatal outcomes were evaluated.
RESULTS: A total of 242 patients, including 112 (46.3 %) pregnant women with epilepsy and 130 (53.7 %) healthy pregnant women, were included in the study. Among pregnant patients with epilepsy, 4 (3.5 %) did not use anti-seizure medications, 79 (70.5 %) received monotherapy, and 29 (25.8 %) received polytherapy. The rates of pregnancy termination, spontaneous abortion, and maternal and fetal complications were significantly higher in pregnant women with epilepsy (p = 0.045, p = 0.045, p < 0.001, and p = 0.016, respectively). Folic acid use, planned pregnancy rate and postpartum breastfeeding rate were all statistically lower in pregnant women with epilepsy (p < 0.001, p < 0.001, p < 0.001, respectively). The rates of intensive care unit stay, infants with birth weight less than 2500 g, congenital malformations, and preterm births were significantly higher in babies born to pregnant women with epilepsy (p < 0.001, p = 0.047, p = 0.003, and p = 0.051, respectively). Gestational diabetes mellitus was observed in 4 (13.8 %) and congenital malformations in 4 (14.3 %) of the pregnant women with epilepsy who received polytherapy, and in both cases these rates were statistically higher than those of pregnant women with epilepsy who received monotherapy (p = 0.048 and p = 0.004, respectively).
CONCLUSIONS: This study demonstrated that pregnancies among women affected by epilepsy have significantly higher rates of maternal and fetal complications, spontaneous abortions, and premature births. Polytherapy with anti-seizure medications is associated with an increased risk of gestational diabetes and congenital anomalies. Notably, folic acid use, planned pregnancy, and postpartum breastfeeding were less common in patients with epilepsy. The most commonly prescribed anti-seizure medications were levetiracetam and lamotrigine. Caesarean section is a common mode of delivery in pregnancies of mothers with epilepsy.
CONCLUSIONS: These results suggest that epilepsy increases both maternal and fetal complications during pregnancy. Furthermore, the use of anti-seizure medications appears to have a significant impact on pregnancy outcomes. Our findings highlight the need for comprehensive management strategies and informed decision making to reduce risks and optimise maternal and fetal outcomes among women with epilepsy.
METHODS: A total of 242 participants were analysed, including 112 with epilepsy and 130 healthy pregnant controls. Maternal age, medical history, seizure characteristics, use of anti-seizure medications, and pregnancy history were recorded. Maternal and fetal complications, delivery modes, and perinatal outcomes were evaluated.
RESULTS: A total of 242 patients, including 112 (46.3 %) pregnant women with epilepsy and 130 (53.7 %) healthy pregnant women, were included in the study. Among pregnant patients with epilepsy, 4 (3.5 %) did not use anti-seizure medications, 79 (70.5 %) received monotherapy, and 29 (25.8 %) received polytherapy. The rates of pregnancy termination, spontaneous abortion, and maternal and fetal complications were significantly higher in pregnant women with epilepsy (p = 0.045, p = 0.045, p < 0.001, and p = 0.016, respectively). Folic acid use, planned pregnancy rate and postpartum breastfeeding rate were all statistically lower in pregnant women with epilepsy (p < 0.001, p < 0.001, p < 0.001, respectively). The rates of intensive care unit stay, infants with birth weight less than 2500 g, congenital malformations, and preterm births were significantly higher in babies born to pregnant women with epilepsy (p < 0.001, p = 0.047, p = 0.003, and p = 0.051, respectively). Gestational diabetes mellitus was observed in 4 (13.8 %) and congenital malformations in 4 (14.3 %) of the pregnant women with epilepsy who received polytherapy, and in both cases these rates were statistically higher than those of pregnant women with epilepsy who received monotherapy (p = 0.048 and p = 0.004, respectively).
CONCLUSIONS: This study demonstrated that pregnancies among women affected by epilepsy have significantly higher rates of maternal and fetal complications, spontaneous abortions, and premature births. Polytherapy with anti-seizure medications is associated with an increased risk of gestational diabetes and congenital anomalies. Notably, folic acid use, planned pregnancy, and postpartum breastfeeding were less common in patients with epilepsy. The most commonly prescribed anti-seizure medications were levetiracetam and lamotrigine. Caesarean section is a common mode of delivery in pregnancies of mothers with epilepsy.
CONCLUSIONS: These results suggest that epilepsy increases both maternal and fetal complications during pregnancy. Furthermore, the use of anti-seizure medications appears to have a significant impact on pregnancy outcomes. Our findings highlight the need for comprehensive management strategies and informed decision making to reduce risks and optimise maternal and fetal outcomes among women with epilepsy.
摘要：
背景：癫痫是一种影响全球相当大比例女性人口的疾病。怀孕期间抗癫痫药物的管理以及对母亲和胎儿的潜在不良后果代表了重大挑战。这项回顾性研究旨在通过比较有癫痫和没有癫痫的孕妇的母婴结局来评估妊娠期抗癫痫药物的影响。
方法：共分析了242名参与者，包括112名癫痫患者和130名健康的孕妇对照组。产妇年龄,病史,癫痫发作特征，使用抗癫痫药物，并记录妊娠史。孕产妇和胎儿并发症，交付模式，并评估围产期结局。
结果：共有242名患者，包括112名(46.3%)癫痫孕妇和130名(53.7%)健康孕妇，包括在研究中。在怀孕的癫痫患者中，4（3.5％）没有使用抗癫痫药物，79人（70.5%）接受单药治疗，29人(25.8%)接受综合疗法。妊娠终止率，自然流产,在妊娠合并癫痫的妇女中,母体和胎儿的并发症明显增高(分别为p=0.045,p=0.045,p<0.001和p=0.016).叶酸的使用，癫痫孕妇的计划妊娠率和产后母乳喂养率均在统计学上较低(分别为p<0.001,p<0.001,p<0.001).重症监护病房的住院率，出生体重低于2500克的婴儿，先天性畸形,妊娠合并癫痫妇女所生婴儿的早产率明显较高(分别为p<0.001,p=0.047,p=0.003和p=0.051).在接受综合治疗的癫痫孕妇中，有4例（13.8％）观察到妊娠糖尿病，有4例（14.3％）观察到先天性畸形，在这两种情况下，这些比率在统计学上都高于接受单药治疗的癫痫孕妇（分别为p=0.048和p=0.004）。
结论：这项研究表明，受癫痫影响的妇女怀孕的母婴并发症发生率明显较高，自然流产,和早产。抗癫痫药物的综合疗法与妊娠糖尿病和先天性异常的风险增加有关。值得注意的是,叶酸的使用，计划怀孕,癫痫患者产后母乳喂养较少见.最常用的抗癫痫药物是左乙拉西坦和拉莫三嗪。剖腹产是癫痫母亲怀孕的常见分娩方式。
结论：这些结果表明，妊娠期癫痫增加了母体和胎儿的并发症。此外，抗癫痫药物的使用似乎对妊娠结局有显著影响.我们的发现强调了全面的管理策略和知情决策的必要性，以降低癫痫妇女的风险并优化母婴结局。
方法：共分析了242名参与者，包括112名癫痫患者和130名健康的孕妇对照组。产妇年龄,病史,癫痫发作特征，使用抗癫痫药物，并记录妊娠史。孕产妇和胎儿并发症，交付模式，并评估围产期结局。
结果：共有242名患者，包括112名(46.3%)癫痫孕妇和130名(53.7%)健康孕妇，包括在研究中。在怀孕的癫痫患者中，4（3.5％）没有使用抗癫痫药物，79人（70.5%）接受单药治疗，29人(25.8%)接受综合疗法。妊娠终止率，自然流产,在妊娠合并癫痫的妇女中,母体和胎儿的并发症明显增高(分别为p=0.045,p=0.045,p<0.001和p=0.016).叶酸的使用，癫痫孕妇的计划妊娠率和产后母乳喂养率均在统计学上较低(分别为p<0.001,p<0.001,p<0.001).重症监护病房的住院率，出生体重低于2500克的婴儿，先天性畸形,妊娠合并癫痫妇女所生婴儿的早产率明显较高(分别为p<0.001,p=0.047,p=0.003和p=0.051).在接受综合治疗的癫痫孕妇中，有4例（13.8％）观察到妊娠糖尿病，有4例（14.3％）观察到先天性畸形，在这两种情况下，这些比率在统计学上都高于接受单药治疗的癫痫孕妇（分别为p=0.048和p=0.004）。
结论：这项研究表明，受癫痫影响的妇女怀孕的母婴并发症发生率明显较高，自然流产,和早产。抗癫痫药物的综合疗法与妊娠糖尿病和先天性异常的风险增加有关。值得注意的是,叶酸的使用，计划怀孕,癫痫患者产后母乳喂养较少见.最常用的抗癫痫药物是左乙拉西坦和拉莫三嗪。剖腹产是癫痫母亲怀孕的常见分娩方式。
结论：这些结果表明，妊娠期癫痫增加了母体和胎儿的并发症。此外，抗癫痫药物的使用似乎对妊娠结局有显著影响.我们的发现强调了全面的管理策略和知情决策的必要性，以降低癫痫妇女的风险并优化母婴结局。
