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zoom RSS 妊娠中のけいれん発作が未熟児や低体重児のリスクを増加

<<   作成日時 : 2009/08/12 00:08   >>

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 妊娠中のてんかん発作は未熟児や低体重児のリスクを増大させるとわかった。台湾での研究で、1,016人のてんかんの女性から生まれた子どもとそうでない8,128人の女性の子どもを比較した。妊娠中にてんかん女性の503人がけいれん発作をおこし、513人には発作がなかった。妊娠中に発作があると、5.5ポンド以下の低出生体重が生まれる割合が36%増加し、在胎37週前の未熟児が生まれる割合が63%高かった。
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Seizures, Not Epilepsy Itself, May Raise Birth Risks
It's the attacks during pregnancy that cause problems, study contends
-- Robert Preidt
http://health.msn.com/pregnancy/articlepage.aspx?cp-documentid=100243064

画像It's the attacks during pregnancy that cause problems, study contends.

MONDAY, Aug. 10 (HealthDay News) -- Epileptic seizures during pregnancy increase the likelihood of premature and small babies, says a new study.

Taiwanese researchers compared children born to 1,016 women with epilepsy with those born to 8,128 women without epilepsy. During pregnancy, 503 of the women with epilepsy had seizures and 513 did not.

Those who had seizures while pregnant were 36 percent more likely than women who did not have epilepsy to have had a baby that weighed less than 5.5 pounds (considered low birth weight), 63 percent more likely to deliver prematurely (before 37 weeks) and 37 percent more likely to have a baby who was small for gestational age.

In another comparison, women with epilepsy who had seizures during pregnancy were 34 percent more likely to have a baby who was small for gestational age than were women with epilepsy who did not have seizures while pregnant.

The study is in the August issue of Archives of Neurology.

Some earlier studies suggested a link between epilepsy and adverse pregnancy outcomes, but others found no connection.

The findings of the new study "suggest that it is the seizures themselves that seem to contribute greatly to the increased risk of infants being delivered preterm, of low birth weight and small for gestational age," wrote Yi-Hua Chen, of Tai Pei Medical University in Taiwan, and colleagues. "For women who remained seizure-free throughout pregnancy, null or mild risk was identified, compared with unaffected women."

Epileptic seizures can affect pregnancy outcomes in a number of ways. Seizures can cause trauma that ruptures fetal membranes, increasing the risk for infection and early delivery. Or seizures can cause contractions in the uterus that cause tension and acute injury.

The researchers emphasized the need for intervention strategies, such as helping women control seizures for a period of time before pregnancy, assisting them in sleeping better, providing education about the risks of seizures while pregnant and teaching them how to cope with stress.

More information

The Epilepsy Foundation has more about women and epilepsy.
SOURCE: JAMA/Archives journals, news release, Aug. 10, 2009

Copyright (c) 2009 ScoutNews, LLC. All rights reserved.

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Affect of Seizures During Gestation on Pregnancy Outcomes in Women With Epilepsy

Yi-Hua Chen, PhD; Hung-Yi Chiou, PhD; Herng-Ching Lin, PhD; Hsiu-Li Lin, MD

Arch Neurol. 2009;66(8):979-984.

Objective To assess whether seizures in women with epilepsy during pregnancy contribute to adverse pregnancy outcomes.

Design A retrospective cross-sectional study.

Setting Taiwan.

Patients This study linked 2 nationwide population-based data sets: Taiwan's birth certificate registry and the Taiwan National Health Insurance Research Data set. A total of 1016 women with epilepsy were selected who had single births from 2001 to 2003 and who had been diagnosed with epilepsy within 2 years prior to their index delivery, together with 8128 matched women without chronic disease as a comparison cohort. Women with epilepsy were further stratified into 2 groups for analysis: women who did and did not have seizures during pregnancy.

Main Outcome Measures Low-birth-weight infants, preterm delivery, and infants who are small for gestational age (SGA).

Results Compared with women without epilepsy, epileptic seizures during pregnancy were independently associated with a 1.36-fold (95% confidence interval [CI], 1.01-1.88), 1.63-fold (95% CI, 1.21-2.19), and 1.37-fold (95% CI, 1.09-1.70) increased risk of low-birth-weight infants, preterm delivery, and SGA, respectively, after adjusting for family income and parental and infant characteristics. Further, the risk of SGA increased significantly (odds ratio, 1.34; 95% CI, 1.01-1.84) for women with seizures during pregnancy compared with women with epilepsy who did not have seizures during pregnancy.

Conclusion We suggest preventing seizures during pregnancy as an essential step to reduce risk of adverse pregnancy outcomes.


Author Affiliations: Schools of Public Health (Drs Chen and Chiou) and Health Care Administration (Dr H.-C. Lin), Taipei Medical University; and the Department of Neurology, General Cathay Hospital, Sijhih Branch, Taipei, Taiwan (Dr H.-L. Lin).



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妊娠中のけいれん発作が未熟児や低体重児のリスクを増加 医師の一分/BIGLOBEウェブリブログ
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