Analysis Of Influencing Factors Of Quality Of Life In Women With Epilepsy And Related Research On Pregnancy

Epilepsy is a common and frequent chronic neurological disease,which has seriously affects the quality of life of patients.Especially for women with epilepsy,they are more affected and the quality of life is worse,because of their special physiological and psychological characteristics.Moreover,most women with epilepsy will be pregnant,the control of seizure during pregnancy and the use of antiepileptic drugs may directly affect the outcome of pregnancy.Therefore,for these patients,more emphasis should be placed on reasonable management of pregnancy.This paper analyzed the impairment characteristics and influencing factors of quality of life in women with epilepsy through scale evaluation,and retrospectively analyzed the control of seizure and the use of antiepileptic drugs during pregnancy and pregnancy outcomes of women with epilepsy.ObjectiveTo study the characteristics and influencing factors of quality of life in women with epilepsy.At the same time,we retrospectively analyzed the seizures,medication and pregnancy outcomes of women with epilepsy during pregnancy,so as to provide clinical basis for reasonable management of pregnancy.MethodsWomen with epilepsy who visited the epilepsy center and obstetrics department of a hospital in Shanghai from 2013 to 2018 were collected.The general situation questionnaire,quality of life questionnaire-31 for epileptic patients were completed.The relationship between influencing factors and quality of life was analyzed and compared by single and multiple factor analysis.The seizures,medication and pregnancy outcomes of women with epilepsy were analyzed retrospectively during pregnancy.Results107 cases women with epilepsy,Among the items of quality of life,the scores of"cognitive function"and"social function"were higher,the scores of other items were lower,and the score of"comprehensive quality of life"was lowest.The scores of different items of quality of life in different age groups were different,and the"drug effect"and"comprehensive quality of life"were statistically significant.Univariate correlation analysis found that age,marriage,employment,number of drugs and seizure frequency were related to the quality of life of women with epilepsy.Multivariate stepwise regression analysis found that age,employment,number of drugs and seizure frequency had influence on the quality of life of women with epilepsy.Among 61 cases epilepsy with pregnancy,26 cases(42.6%)had epileptic seizures during pregnancy,there was no significant change in seizure frequency in 45patients(73.8%).23 cases suffered epileptic seizures within one year before pregnancy,17 cases suffered epileptic seizures again during pregnancy,38 cases had no epileptic seizures within one year before pregnancy,and 9 cases suffered epileptic seizures again during pregnancy.After analysis,it was found that patients who had epileptic seizures within one year before pregnancy were more likely to have epileptic seizures during pregnancy.The difference was statistically significant(χ~2=14.781,P=0.000).52 cases(85.2%)were treated with oral antiepileptic drugs during pregnancy,41 cases(67.2%)were treated with monotherapy and 11 cases(18%)were treated with polytherapy.Among the patients treated with monotherapy,the most frequently used antiepileptic drugs were carbamazepine(29.27%),levetiracetam(31.71%)and lamotrigine(14.63%).9 cases(14.8%)had adverse pregnancy outcomes,including 4 cases of premature births(6.6%),3 cases of low birth weight(4.9%),2 cases of newborns(3.3%)with Apgar score below 7,2 cases of induced labor(3.3%)and 1 cases of prenatal hemorrhage(1.64%).The incidence of adverse pregnancy outcomes in patients with epileptic seizures within one year before pregnancy was significantly higher than patients without epileptic seizures within one year before pregnancy,and the difference was statistically significant(χ~2=5.355,P=0.021);the incidence of adverse pregnancy outcomes in patients with epileptic seizures during pregnancy was also significantly higher than patients without epileptic seizures during pregnancy,the difference was statistically significant(χ~2=7.155,P=0.007).Conclusions1、In women with epilepsy,the older the patient is,the worse the overall quality of life of the patient is.Women who want to be pregnant are more worried about the impact of antiepileptic drugs.2、Age,employment,number of drugs and seizure frequency have influence on the quality of life of women with epilepsy.Seizure frequency and employment affect many aspects of the quality of life.3、Although a small number of epilepsy with pregnancy have adverse pregnancy outcomes,most of them have relatively stable epilepsy control during pregnancy and can give birth to healthy offspring.4、The main therapeutic drugs for epilepsy with pregnancy are new antiepileptic drugs,represented by levetiracetam and lamotrigine,and the use of valproate sodium has been significantly reduced.5、Epileptic seizures during pregnancy and within one year before pregnancy may lead to adverse pregnancy outcomes.Epileptic seizures within one year before pregnancy are the predictor of epileptic seizures during pregnancy.