全身性和局灶性癫痫与妊娠、分娩和新生儿结局：一项回顾性队列研究

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior Pub Date : 2025-08-02 DOI:10.1016/j.yebeh.2025.110640

Noah Margolese , Ahmad Badeghiesh , Haitham Baghlaf , Aaron Samuels , Michael H. Dahan

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引用次数: 0

摘要

我们之前证明了母体癫痫与妊娠结局之间的关联。现在，我们试图确定这些结果是否在全身性癫痫和局灶性癫痫之间有所不同。使用HCUP-NIS数据库完成回顾性队列研究。通过ICD-9代码确定全身性和局灶性癫痫类型，比较妊娠结局。在2596例妊娠中，1978例为局灶性癫痫，618例为全身性癫痫。与全面性癫痫相比，局灶性癫痫与剖宫产率增加相关（aOR = 1.27; 95% CI = 1.02-1.57;p = 0.030）。其他妊娠结局无显著差异，包括妊高征、妊娠期高血压、先兆子痫、先兆子痫、先兆子痫和合并高血压的子痫、妊娠糖尿病、前置胎盘、早产、胎膜早破、早产、胎盘早剥、绒毛膜羊膜炎、阴道手术分娩、子宫切除术、产后出血、伤口并发症、孕产妇死亡、输血、孕产妇感染、深静脉血栓形成，肺栓塞，静脉血栓栓塞，弥散性血管内凝血，小于胎龄，宫内胎儿死亡和先天性异常(P >；0.05,所有)。与全身性癫痫相比，局灶性癫痫与年龄更小有关(p <；0.001)、收入较低四分位数（p = 0.013）、怀孕期间吸烟（p = 0.037）和非法使用药物(p <；0.001)。局灶性癫痫患者比全身性癫痫患者更有可能获得医疗补助，而较少可能获得医疗保险或私人保险(p <；0.001)。在其他母性特征方面没有观察到显著差异。局灶性癫痫患者通过剖宫产分娩的风险高于全身性癫痫患者。原因尚不清楚。令人放心的是，与局灶性癫痫相比，全身性癫痫不会增加其他妊娠并发症。

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Generalized and focal epilepsy and pregnancy, delivery and neonatal outcomes: a retrospective cohort study

We previously demonstrated associations between maternal epilepsy and pregnancy outcomes. Now, we seek to determine whether these outcomes differ between generalized and focal epilepsy.

A retrospective cohort study was completed using the HCUP-NIS database. Pregnancy outcomes were compared across generalized and focal epilepsy types, as determined via ICD-9 codes.

Of 2,596 pregnancies, 1978 women had focal epilepsy and 618 had generalized epilepsy. Focal epilepsy was associated with increased rates of cesarean sections as compared to generalized epilepsy (aOR = 1.27;95 %CI = 1.02–1.57;p = 0.030). Other pregnancy outcomes did not differ significantly, including pregnancy induced hypertension, gestational hypertension, preeclampsia, eclampsia, preeclampsia and eclampsia superimposed on pre-existing hypertension, gestational diabetes mellitus, placenta previa, preterm premature rupture of membranes, preterm delivery, abruptio placenta, chorioamnionitis, operative vaginal delivery, hysterectomy, postpartum hemorrhage, wound complications, maternal death, transfusion, maternal infection, deep venous thrombosis, pulmonary embolism, venous thromboembolism, disseminated intravascular coagulation, small for gestational age, intrauterine fetal demise and congenital anomalies (P > 0.05, all). As compared to generalized epilepsy, focal epilepsy was associated with younger age (p < 0.001), lower income quartile (p = 0.013), tobacco smoking during pregnancy (p = 0.037) and illicit drug use (p < 0.001). Women with focal epilepsy were more likely than those with generalized epilepsy to be covered by Medicaid and less likely to be covered through Medicare or private insurance (p < 0.001). No significant differences were observed regarding other maternal characteristics.

Women with focal epilepsy are at a higher risk of delivery through cesarean section than those with generalized epilepsy. The reason why remains unclear. Reassuringly, other pregnancy complications are not increased by generalized as opposed to focal epilepsy.

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来源期刊

Epilepsy & Behavior 医学-行为科学

CiteScore

5.40

自引率

15.40%

发文量

385

审稿时长

43 days

期刊介绍： Epilepsy & Behavior is the fastest-growing international journal uniquely devoted to the rapid dissemination of the most current information available on the behavioral aspects of seizures and epilepsy. Epilepsy & Behavior presents original peer-reviewed articles based on laboratory and clinical research. Topics are drawn from a variety of fields, including clinical neurology, neurosurgery, neuropsychiatry, neuropsychology, neurophysiology, neuropharmacology, and neuroimaging. From September 2012 Epilepsy & Behavior stopped accepting Case Reports for publication in the journal. From this date authors who submit to Epilepsy & Behavior will be offered a transfer or asked to resubmit their Case Reports to its new sister journal, Epilepsy & Behavior Case Reports.