[Influence of maternal neuropsychiatric disorders on clinical course of pregnancy and neonatal outcome].

Nihon Sanka Fujinka Gakkai zasshi Pub Date : 1996-11-01
R Takeuchi
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Abstract

The obstetric course and neonatal outcome were studied in 35 pregnant women with neuropsychiatric disorders who were admitted to Toho University Ohmori Hospital between 1981 and 1990. The rate of live births associated with psychiatric disease was 0.49% (40 of 8.191 deliveries). These were schizophrenia (N = 17), epilepsy (N = 12), depression (N = 2), neurosis (N = 3) and psychogenic response (N = 1). Iron deficiency anemia was observed in 8 of 16 epileptic women. Cesarean section or vacuum extraction were performed in 15 of 40 cases (37.5%). The indications for these procedures were uncontrollable psychotic symptoms in all of 6 schizophrenic women, while those in all 7 epileptic women were obstetrical. Symptoms of schizophrenia became worse in 33.3% and 50% of the patients during and after birth, respectively. The incidence of preterm delivery was 15%, and 25% of newborn infants were of low birthweight. Drug withdrawal symptoms were observed in 4 of 16 infants (25%) born to epileptic mothers. Three of 10 offspring of epileptic mothers were affected by febrile convulsions within 6 years of age. Although a relatively higher incidence of obstetric complications has recognized, there seem to be no specific complications in epileptic or psychiatric women. Our results also suggest the importance and need for close cooperation between the obstetrician and psychiatrist, and a follow-up program for offspring.

[产妇神经精神障碍对妊娠临床过程和新生儿结局的影响]。
研究了1981年至1990年间在东宝大学大森医院收治的35名患有神经精神疾病的孕妇的产科过程和新生儿结局。与精神疾病相关的活产率为0.49%(8.191例分娩中有40例)。精神分裂症(17例)、癫痫(12例)、抑郁症(2例)、神经症(3例)、心因性反应(1例)。16例癫痫患者中有8例出现缺铁性贫血。40例患者中有15例(37.5%)行剖宫产或抽吸术。所有6例精神分裂症妇女的适应症均为无法控制的精神病症状,而所有7例癫痫妇女的适应症均为产科。分别有33.3%和50%的患者在出生时和出生后精神分裂症症状加重。早产发生率为15%,新生儿低出生体重率为25%。癫痫母亲所生的16名婴儿中有4名(25%)出现药物戒断症状。10个癫痫母亲的后代中有3个在6岁以内受到热性惊厥的影响。虽然产科并发症的发生率相对较高,但癫痫或精神病妇女似乎没有具体的并发症。我们的结果也提示产科医生和精神科医生密切合作的重要性和必要性,以及对后代的随访计划。
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