女性癲癇患者的福音到了。最新研究顯示,，女性癲癇患者在哺乳期間服用治療藥物并不會對孩子將來的智力造成傷害,。該研究發(fā)表在11月24日出版的美國神經(jīng)學(xué)會的在線醫(yī)學(xué)雜志《神經(jīng)學(xué)》上。
“盡管此項研究還需要擴(kuò)展到更多孕婦和嬰兒身上,，但對于那些既想要讓自己的孩子享受到母乳喂養(yǎng)的好處,，又需要持續(xù)服藥控制癲癇的婦女來說，目前的這些結(jié)果已經(jīng)可以讓她們安心了,。”該研究作者,、亞特蘭大艾默里大學(xué)的醫(yī)學(xué)博士兼美國神經(jīng)學(xué)會研究學(xué)者Kimford Meador說。
該研究跟蹤了194位正在服用癲癇藥物的孕婦,。她們生下的總共199個嬰兒中,，42%是母乳喂養(yǎng)。當(dāng)這些嬰孩長到三歲的時候,，研究人員對他們進(jìn)行了智商測試,。
研究發(fā)現(xiàn)，與非母乳喂養(yǎng)的孩子相比,，那些由母乳喂養(yǎng)的孩子的智商并沒有什么不同,。其中，由母乳喂養(yǎng)的孩子在測試中得到99的分?jǐn)?shù),，而對照組的孩子的得分為98,，區(qū)別并不大,。
這些參加研究的婦女服用的藥物包括卡馬西平（carbamazepine）,、拉莫三嗪（lamotrigine）,、苯妥英（phenytoin）和丙戊酸鈉（valproate）。Meador表示,，還需要對其它的癲癇藥物及相關(guān)新藥的影響結(jié)果做進(jìn)一步的研究,。那些服用丙戊酸鈉的婦女的孩子總體來說智商測試結(jié)果較低，不論他們是否是母乳喂養(yǎng),。美國神經(jīng)學(xué)會的指導(dǎo)手冊上明確建議,，女性癲癇患者在孕期應(yīng)避免服用丙戊酸鈉，以減少嬰兒出生缺陷和認(rèn)知障礙的風(fēng)險,。指導(dǎo)手冊同時建議,，女性癲癇患者在孕期應(yīng)避免一次性攝入一種以上的癲癇藥物，因為有研究顯示,，服用一種以上的癲癇藥物會增加嬰兒患上出生缺陷的風(fēng)險,。
該文章的編輯作者、布萊根婦女醫(yī)院和哈佛醫(yī)學(xué)院的Autumn Klein醫(yī)學(xué)博士說,，如此大規(guī)模地對哺乳期服用癲癇藥物的影響進(jìn)行研究,，這幾乎是首次。
“因為缺乏對這些藥物的副作用的信息,，很多婦女得到了不能哺乳的建議,，但是母乳喂養(yǎng)對母親和孩子均有多種積極的情感作用，同時還能降低孩子患心臟病,、糖尿病和肥胖癥的風(fēng)險,，并幫助母親預(yù)防乳癌和卵巢癌。”Klein說,，“這項研究突顯出我們當(dāng)前急需更多癲癇藥物在母乳喂養(yǎng)方面的信息及其長期影響,。”（生 物 谷Bioon.com）
生 物 谷推薦英文摘要：
Neurology doi: 10.1212/WNL.0b013e3181ffe4a9
Effects of breastfeeding in children of women taking antiepileptic drugs
K.J. Meador, MD, G.A. Baker, PhD, N. Browning, PhD, J. Clayton-Smith, MD, D.T. Combs-Cantrell, MD, M. Cohen, EdD, L.A. Kalayjian, MD, A. Kanner, MD, J.D. Liporace, MD, P.B. Pennell, MD, M. Privitera, MD, D.W. Loring, PhD and For the NEAD Study Group
From Neurology (K.J.M., D.W.L.), Emory University, Atlanta, GA; Walton Centre for Neurology & Neurosurgery (G.A.B.), University of Liverpool, Merseyside, UK; EMMES Corp. (N.B.), Rockville, MD; St. Mary's Hospital (J.C.-S.), Manchester, UK; University of Texas-Southwestern (D.T.C.-C.), Dallas; Neurology (M.C.), Medical College of Georgia, Augusta; University of Southern California (L.A.K.), Los Angeles; Rush University Medical Center (A.K.), Chicago, IL; Neurology (J.D.L.), Riddle Health Care, Media, PA; Neurology (P.B.P.), Brigham & Women's Hospital, Boston, MA; and Neurology (M.P.), University of Cincinnati, Cincinnati, OH.
Background: Breastfeeding is known to have beneficial effects, but there is concern that breastfeeding during antiepileptic drug (AED) therapy may be harmful to cognitive development. Animal and human studies have demonstrated that some AEDs can adversely affect the immature brain. However, no investigation has examined effects of breastfeeding during AED therapy on subsequent cognitive abilities in children.
Methods: The Neurodevelopmental Effects of Antiepileptic Drugs Study is an ongoing prospective multicenter observational investigation of long-term effects of in utero AED exposure on cognition. Between 1999 and 2004, we enrolled pregnant women with epilepsy who were taking a single AED (carbamazepine, lamotrigine, phenytoin, or valproate). We recently reported on differential AED effects on age 3 year cognitive outcomes. In this report, we focus on the effects of breastfeeding during AED therapy on age 3 cognitive outcomes in 199 children.
Results: A total of 42% of children were breastfed. IQs for breastfed children did not differ from nonbreastfed children for all AEDs combined and for each of the 4 individual AED groups. Mean adjusted IQ scores (95% confidence intervals) across all AEDs were breastfed = 99 (96–103) and nonbreastfed = 98 (95–101). Power was 95% to detect a half SD IQ effect in the combined AED analysis, but was inadequate within groups.
Conclusions: This preliminary analysis fails to demonstrate deleterious effects of breastfeeding during AED therapy on cognitive outcomes in children previously exposed in utero. However, caution is advised due to study limitations. Additional research is needed to confirm this observation and extend investigations to other AEDs and polytherapy.
