女性癫痫患者怀孕机率不受影响

来源：纽约大学医学院

2016年4月16日

链接：https://www.sciencedaily.com/releases/2016/04/160416094748.htm

多校合作的一项新研究成果显示，女性癫痫患者可以像那些没有神经系统疾病的妇女一样成功怀孕。

在一项前瞻性研究中，研究人员发现有癫痫病的妇女成功怀孕的可能性与正常人一样，而且在怀孕时机及妊娠成功率上也与正常人类似。这项将于4月17日在美国神经科学学会于温哥华举行的第六十八届年会上公布的研究结果与医学界以前所确信的事实刚好相反，因为在此之前医学界一直认为患有癫痫症的妇女生育能力低下。

癫痫基金会资助的这项新研究显示，美国有超过110万名患有癫痫的妇女处于生育年龄，而且每年患有癫痫的妇女会产下约24，000名婴儿。以前的研究曾经认为，女性癫痫患者的不孕率比正常人高两到三倍，即约有三分之一患有癫痫症的女性有不孕问题。但是，据本论文的作者说，目前为止还没有系统全面的研究数据来证实上述假说。

“我们希望我们的发现能让女性癫痫患者及相关医生感到更加放心，” 纽约大学Langone癫痫转化研究和临床试验综合科主任、神经学教授、该研究的第一作者兼共同通讯作者Jacqueline French博士说。 她带领的科学家团队开展了一项涉及多个实验的观察性研究，该研究名为“女性癫痫患者的妊娠结果（WEPOD）”。该研究从2010年开始直到2015年结束。参与研究的癫痫病患者及健康对照者的年龄处于18岁至41岁之间，在研究开始时正在尝试怀孕，而且在研究开始6个月内成功受孕。这些实验参与者在整个孕期都接受了研究者的追访。电子日记详细记录了她们使用抗癫痫药物、癫痫发作以及相关性生活和月经周期的数据。总共有89名女性癫痫患者和109名健康对照者参与了该实验研究。研究结果显示，癫痫症患者的怀孕比例为70%，而健康对照组的怀孕比例为67.1%。癫痫患者尝试受孕的平均时间为6.03个月，而健康对照组中该数据为9.05个月。在考虑了年龄、身体质量指数、种族等因素并对结果做了相应的统计调整以后，研究者在两组样本的尝试受孕时间上没有发现任何差异。对于已经成功发生的妊娠而言，两组的活产率（81.8%的癫痫女性患者及80%的对照者）及流产率（12.7%的癫痫女性患者和20%的对照者）相似。

Women with epilepsy are just as likely to achieve a successful pregnancy as women without the neurological disorder, according to a new study led by research teams at multiple centers, including NYU Langone Medical Center.

In a prospective study, women with epilepsy had a comparable likelihood of achieving pregnancy, time taken to get pregnant, and pregnancy outcomes such as miscarriage, compared to a group of healthy peers. These findings, presented April 17 at the American Academy of Neurology's 68th Annual Meeting in Vancouver, contradict previously held beliefs in the medical community regarding the fertility of women with epilepsy.

More than 1.1 million U.S. women with epilepsy are of childbearing age and approximately 24,000 babies are born to women with epilepsy each year, according to figures from The Epilepsy Foundation, which funded the new research.

Previous studies have found infertility rates up to two to three times higher for women with epilepsy, or that as many as one-third of women with epilepsy may experience difficulty with pregnancy. But, a comprehensive study has not been done to date to confirm this until now, according to the researchers.

"We hope our findings reassure women with epilepsy and clinicians who are counseling these women on family planning," says Jacqueline French, MD, professor of Neurology and Director of Translational Research and Clinical Trials at NYU Langone's Comprehensive Epilepsy Center, and the study's first author and co-principal investigator.

The researchers led a multicenter observational study called The Women with Epilepsy: Pregnancy Outcomes and Deliveries (WEPOD) from 2010 to 2015. Women with epilepsy and healthy control participants who were between the ages of 18 and 41 seeking pregnancy and less than six months removed from contraception were followed throughout the duration of their pregnancy. Electronic diaries captured use of anti-epileptic medications, seizures and facts about participants' sexual activity and menstruation cycles.

In total, 89 women with epilepsy and 109 healthy controls with similar demographics were compared for the study. The proportion of women who achieved pregnancy was 70 percent for women with epilepsy and 67.1 percent for healthy controls.

Average time to pregnancy in women with epilepsy was 6.03 months, compared with 9.05 months for healthy controls, and after controlling for age, body mass index, parity and race, there was no difference across groups for time to pregnancy.

Of the pregnancies that occurred, a similar proportion resulted in live birth (81.8 percent women with epilepsy and 80 percent controls), miscarriage (12.7 percent women with epilepsy and 20 percent controls), or other outcomes (5.4 percent women with epilepsy compared to 0 percent healthy controls).

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The above post is reprinted from materials provided by NYU Langone Medical Center / New York University School of Medicine. Note: Materials may be edited for content and length.