女性癫痫患者妊娠登记的研究进展_Journal of Epilepsy

Authors：

袁方 ,  江文

空军军医大学西京医院神经内科（西安 710032）;

Corresponding author：

江文, Email: jiangwen@fmmu.edu.cn

Keywords：

癫痫妊娠登记; 致畸性; 进展

DOI：

10.7507/2096-0247.20180010

Video：

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女性癫痫患者妊娠期的药物治疗缺乏等级较高的临床证据支持，而单中心研究很难纳入足够大的样本，并且对妊娠期癫痫患者进行随机对照试验也不符合医学伦理，因而多国家、多中心合作的癫痫妊娠登记系统应运而生。目前国际上最大三个癫痫妊娠登记分别为英国及爱尔兰癫痫妊娠登记（the UK and Ireland Epilepsy and Pregnancy Registers，UKIEPR）、北美抗癫痫药物妊娠登记（the North American AED Pregnancy Registry）和国际抗癫痫药物妊娠登记（International Registry of Antiepileptic Drugs and Pregnancy，EURAP）。文章首先简要介绍上述三大癫痫妊娠登记，并对这三大登记系统的方法学等特点进行比较，其次从多角度总结国外癫痫妊娠登记的研究成果，最后简述癫痫与妊娠登记的延伸研究，以期为我国抗癫痫药物妊娠登记的开展提供有益借鉴。

Citation： 袁方, 江文. 女性癫痫患者妊娠登记的研究进展. Journal of Epilepsy, 2018, 4(1): 40-43. doi: 10.7507/2096-0247.20180010 Copy

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5.	Campbell E, Kennedy F, Russell A, et al. Malformation risks of antiepileptic drug monotherapies in pregnancy: updated results from the UK and Ireland Epilepsy and Pregnancy Registers. J Neurol Neurosurg Psychiatry, 2014, 85(1): 1029-1034.
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7.	Tomson T, Battino D, Bonizzoni E, et al. EURAP: an international registry of antiepileptic drugs and pregnancy. Epilepsia, 2004, 45(11): 1463-1464.
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12.	Thomas SV, Indrani L, Devi GC, et al. Pregnancy in women with epilepsy preliminary results of kerala registry of epilepsy and pregnancy. Neurol India, 2001, 49(1): 60-66.
13.	Tomson T, Battino D, Bonizzoni E, et al. Dose-dependent risk of malformations with antiepileptic drugs: an analysis of data from the EURAP epilepsy and pregnancy registry. The Lancet Neurology, 2011, 10(2): 609-617.
14.	Jentink J, Loane MA, Dolk H, et al. Valproic acid monotherapy in pregnancy and major congenital malformations. N Engl J Med, 2010, 362(23): 2185-2193.
15.	Hunt S, Russell A, Smithson WH, et al. Topiramate in pregnancy: preliminary experience from the UK Epilepsy and Pregnancy Register. Neurology, 2008, 71(4): 272-276.
16.	Mawhinney E, Craig J, Morrow J, et al. Levetiracetam in pregnancy: results from the UK and Ireland Epilepsy and Pregnancy Registers. Neurology, 2013, 80(4): 400-405.
17.	Holmes LB, Mittendorf R, Shen A, et al. Fetal effects of anticonvulsant polytherapies: different risks from different drug combinations. Arch Neurol, 2011, 68(2): 1275-1281.
18.	ChristiansonA, Howson CP, Modell B. Global report on birth defects [EB/OL]. http://www.marchofdimes.com/globalreport1.
19.	Tomson T, Battino D. Teratogenic effects of antiepileptic drugs. The Lancet Neurology, 2012, 11(4): 803-813.
20.	Campbell E, Devenney E, Morrow J, et al. Recurrence risk of congenital malformations in infants exposed to antiepileptic drugs in utero. Epilepsia, 2013, 54(9): 165-171.
21.	Vajda FJ, O'Brien TJ, Lander CM, et al. Teratogenesis in repeated pregnancies in antiepileptic drug-treated women. Epilepsia, 2013, 54(5): 181-186.
22.	Meador KJ, Baker GA, Browning N, et al. Fetal antiepileptic drug exposure and cognitive outcomes at age 6 years (NEAD study): a prospective observational study. The Lancet Neurology, 2013, 12(7): 244-252.
23.	Baker GA, Bromley RL, Briggs M, et al. IQ at 6 years after in utero exposure to antiepileptic drugs a controlled cohort study. Neurology, 2015, 84(4): 382-390.
24.	Meador KJ, Baker GA, Browning N, et al. Breastfeeding in children of women taking antiepileptic drugs: cognitive outcomes at age 6 years. JAMA Pediatr, 2014, 168(5): 729-736.
25.	Christensen J, Grønborg TK. Prenatal valproate exposure and risk of autism spectrum disorders and childhood autism . JAMA, 2013, 309(16): 1696-1703.
26.	Viale L, Allotey J, Cheong-See F, et al. Epilepsy in pregnancy and reproductive outcomes: a systematic review and meta-analysis. The Lancet, 2015, 386(10006): 1845-1852.

1. Delgado-Escueta AV, Janz D. Consensus guidelines preconception counseling, management, and care of the pregnant woman with epilepsy. Neurology, 1992, 42(4 Suppl 5): 149-160.
2. Lindhout D, Höppener RJ, Meinardi H. Teratogenicity of antiepileptic drug combinations with special emphasis on epoxidation of carbamazepine. Epilepsia, 1984, 25(1): 77-83.
3. Scolnik D, Nulman I, Rovet J, et al. Neurodevelopment of children exposed in utero to phenytoin and carbamazepine monotherapy. JAMA, 1994, 271(10): 767-770.
4. Morrow J, Russell A, Guthrie E, et al. Malformation risks of antiepileptic drugs in pregnancy: a prospective study from the UK Epilepsy and Pregnancy Register. J Neurol Neurosurg Psychiatry, 2006, 77(2): 193-198.
5. Campbell E, Kennedy F, Russell A, et al. Malformation risks of antiepileptic drug monotherapies in pregnancy: updated results from the UK and Ireland Epilepsy and Pregnancy Registers. J Neurol Neurosurg Psychiatry, 2014, 85(1): 1029-1034.
6. Hernandez-Diaz S, Smith CR, Shen A, et al. Comparative safety of antiepileptic drugs during pregnancy. Neurology, 2012, 78(2): 1692-1699.
7. Tomson T, Battino D, Bonizzoni E, et al. EURAP: an international registry of antiepileptic drugs and pregnancy. Epilepsia, 2004, 45(11): 1463-1464.
8. King PB, Lie RT, Irgens LM, et al. Spina bifida and cleft lip among newborns of Norwegian women with epilepsy: changes related to the use of anticonvulsants. Am J Public Health, 1996, 86(10): 1454-1456.
9. Kilic D, Pedersen H, Kjaersgaard MI, et al. Birth outcomes after prenatal exposure to antiepileptic drugs-a population-based study. Epilepsia, 2014, 55(7): 1714-1721.
10. Vajda FJ, O'Brien TJ, Lander CM, et al. The teratogenicity of the newer antiepileptic drugs - an update. Acta Neurol Scand, 2014, 130(4): 234-238.
11. Cunnington MC, Weil JG, Messenheimer JA, et al. Final results from 18 years of the International Lamotrigine Pregnancy Registry. Neurology, 2011, 76(21): 1817-1823.
12. Thomas SV, Indrani L, Devi GC, et al. Pregnancy in women with epilepsy preliminary results of kerala registry of epilepsy and pregnancy. Neurol India, 2001, 49(1): 60-66.
13. Tomson T, Battino D, Bonizzoni E, et al. Dose-dependent risk of malformations with antiepileptic drugs: an analysis of data from the EURAP epilepsy and pregnancy registry. The Lancet Neurology, 2011, 10(2): 609-617.
14. Jentink J, Loane MA, Dolk H, et al. Valproic acid monotherapy in pregnancy and major congenital malformations. N Engl J Med, 2010, 362(23): 2185-2193.
15. Hunt S, Russell A, Smithson WH, et al. Topiramate in pregnancy: preliminary experience from the UK Epilepsy and Pregnancy Register. Neurology, 2008, 71(4): 272-276.
16. Mawhinney E, Craig J, Morrow J, et al. Levetiracetam in pregnancy: results from the UK and Ireland Epilepsy and Pregnancy Registers. Neurology, 2013, 80(4): 400-405.
17. Holmes LB, Mittendorf R, Shen A, et al. Fetal effects of anticonvulsant polytherapies: different risks from different drug combinations. Arch Neurol, 2011, 68(2): 1275-1281.
18. ChristiansonA, Howson CP, Modell B. Global report on birth defects [EB/OL]. http://www.marchofdimes.com/globalreport1.
19. Tomson T, Battino D. Teratogenic effects of antiepileptic drugs. The Lancet Neurology, 2012, 11(4): 803-813.
20. Campbell E, Devenney E, Morrow J, et al. Recurrence risk of congenital malformations in infants exposed to antiepileptic drugs in utero. Epilepsia, 2013, 54(9): 165-171.
21. Vajda FJ, O'Brien TJ, Lander CM, et al. Teratogenesis in repeated pregnancies in antiepileptic drug-treated women. Epilepsia, 2013, 54(5): 181-186.
22. Meador KJ, Baker GA, Browning N, et al. Fetal antiepileptic drug exposure and cognitive outcomes at age 6 years (NEAD study): a prospective observational study. The Lancet Neurology, 2013, 12(7): 244-252.
23. Baker GA, Bromley RL, Briggs M, et al. IQ at 6 years after in utero exposure to antiepileptic drugs a controlled cohort study. Neurology, 2015, 84(4): 382-390.
24. Meador KJ, Baker GA, Browning N, et al. Breastfeeding in children of women taking antiepileptic drugs: cognitive outcomes at age 6 years. JAMA Pediatr, 2014, 168(5): 729-736.
25. Christensen J, Grønborg TK. Prenatal valproate exposure and risk of autism spectrum disorders and childhood autism . JAMA, 2013, 309(16): 1696-1703.
26. Viale L, Allotey J, Cheong-See F, et al. Epilepsy in pregnancy and reproductive outcomes: a systematic review and meta-analysis. The Lancet, 2015, 386(10006): 1845-1852.

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