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首页> 外文期刊>American journal of medical genetics, Part A >Antiepileptic drugs and pregnancy outcomes
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Antiepileptic drugs and pregnancy outcomes

机译：抗癫痫药和妊娠结局

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The treatment of epilepsy in women of reproductive age remains a clinical challenge. While most women with epilepsy (WWE) require anticonvulsant drugs for adequate control of their seizures, the teratogenicity associated with some antiepileptic drugs (AEDs) is a risk that needs to be carefully addressed. Antiepileptic medications are also used to treat an ever broadening range of medical conditions such as bipolar disorder, migraine prophylaxis, cancer, and neuropathic pain. Despite the fact that the majority of pregnancies of WWE who are receiving pharmacological treatment are normal, studies have demonstrated that the risk of having a pregnancy complicated by a major congenital malformation is doubled when comparing the risk of untreated pregnancies. Furthermore, when AEDs are used in polytherapy regimens, the risk is tripled, especially when valproic acid (VPA) is included. However, it should be noted that the risks are specific for each anticonvulsant drug. Some investigations have suggested that the risk of teratogenicity is increased in a dose-dependent manner. More recent studies have reported that in utero exposure to AEDs can have detrimental effects on the cognitive functions and language skills in later stages of life. In fact, the FDA just issued a safety announcement on the impact of VPA on cognition (Safety Announcement 6-30-2011). The purpose of this document is to review the most commonly used compounds in the treatment of WWE, and to provide information on the latest experimental and human epidemiological studies of the effects of AEDs in the exposed embryos.
机译：育龄妇女的癫痫治疗仍然是临床挑战。尽管大多数癫痫妇女需要抗惊厥药才能充分控制癫痫发作，但与某些抗癫痫药（AED）相关的致畸性是一种风险，需要谨慎解决。抗癫痫药也用于治疗越来越多的医学疾病，例如躁郁症，偏头痛预防，癌症和神经性疼痛。尽管接受药物治疗的WWE的大多数孕妇是正常的，但研究表明，与未接受治疗的孕妇进行比较时，妊娠合并主要先天性畸形的风险增加了一倍。此外，在多联疗法中使用AED时，风险会增加三倍，尤其是当包含丙戊酸（VPA）时。但是，应注意的是，每种抗惊厥药的风险都是特定的。一些研究表明，致畸风险以剂量依赖性方式增加。最近的研究报告说，子宫内接触AED可能会对生命后期的认知功能和语言技能产生不利影响。实际上，FDA刚刚发布了有关VPA对认知影响的安全公告（安全公告6-30-2011）。本文档的目的是回顾治疗WWE的最常用化合物，并提供有关AED在裸露的胚胎中的作用的最新实验和人类流行病学研究的信息。

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