てんかんをもつ女性の妊娠・出産

Pregnancy and Childbirth in Women With Epilepsy

てんかんをもつ女性は妊娠可能年齢をむかえるにあたり，抗発作薬による催奇形性や子どもの神経発達症に与える影響を考慮し，安全で効果的な治療をしなくてはならない。さらに，妊娠前から産後にかけて切れ目のないケアを実現するためには多機関，多職種における協働が必要となる。多職種の専門知識を活用していくとともに，診療ガイドを用いて基本的知識を共有し，妊娠前からプレコンセプションケアを行うことが重要である。

Abstract

Women with epilepsy (WWE) need effective and safe treatment during the childbearing age. Administration of antiseizure medications to WWE during pregnancy may be associated with risks to the fetus, including major congenital malformations and negative developmental outcomes. Therefore, preconception care is essential for WWE. Multidisciplinary approaches with interprofessional collaboration are important to support WWE during pregnancy and childbirth; however, such collaboration may be complicated and difficult. Moreover, the prevalence of perinatal depression among WWE is higher than that in the general population. Health care professionals should determine factors associated with perinatal mental health concerns among WWE. Previous meta-analysis have reported that perinatal mental health disorders were associated with a three-fold higher risk of child maltreatment. Therefore, perinatal mental health care is important for WWE.