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【科普】孕期服用抗癫痫药可能会降低孩子智商 Epilepsy drug in pregnancy may lower child's IQ

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Epilepsy drug in pregnancy may lower child's IQ

http://www.washingtonpost.com/wp-dyn/content/article/2009/04/15/AR2009041502671.html
By MIKE STOBBE
The Associated Press
Wednesday, April 15, 2009; 5:00 PM

ATLANTA -- Toddlers of moms who took the epilepsy drug valproate during pregnancy had lower IQs than the children of women who used other anti-seizure medicines, according to a new study.

The valproate children had IQ scores six to nine points lower by age 3, said the study's lead author, Dr. Kimford Meador of Emory University. The drug, also sold in the U.S. under the brand name Depakote, had previously been linked to birth defects, particularly spina bifida. Women of childbearing age have long been advised to avoid it.

"We've known this drug is a bad actor for a long time," said Dr. Lewis Holmes, director of the North American Antiepileptic Disease Pregnancy Registry, based at Massachusetts General Hospital in Boston.

The new study is important because it's the largest to show a connection between valproate and diminished IQ. Its publication in the prestigious New England Journal of Medicine should alert physicians who until now have ignored the drug's potential dangers to fetuses, added Holmes, who was not involved with the study.

In the United States, about 25,000 children are born each year to women who have epilepsy, a brain disorder that causes people to have recurring seizures. In the study, researchers followed pregnant women in the United States and United Kingdom between 1999 and 2004. The results are based on about 260 of their children.

Toddlers whose mothers had taken valproate had IQs of 92, on average. In contrast, IQ scores were in the range of 98 to 101 for children of women who had taken lamotrigine, phenytoin, and carbamazepine. IQ tests are designed so a child of average intelligence scores 100.

The higher the dosage of valproate a woman had taken, the lower the IQ of the child, the researchers found. For the other drugs, dosage levels made no significant difference.

The number of children in the study is small, and it's possible that other factors influenced the results. However, the researchers accounted for differences in a child's birth weight, the age and IQs of their mothers, the type of epilepsy the mothers had, and other factors that could have influenced the results.

A major drawback is that the study did not include children whose epileptic mothers took no medication during pregnancy, Holmes said.

It's possible that all four epilepsy medications had some effect on mental development, he said. Without such a comparison group, it's hard to know, said Holmes, who is also a professor of pediatrics at Harvard Medical School.

Valproate, also given for migraine headaches and mood disorders, continues to be used by some epileptics because it's the only thing that works, said Meador, the study author.

Doctors say it's often important for epileptic women to keep taking their medications during pregnancy because seizures can lead to injuries.

Women on the drug who want to get pregnant should plan their pregnancies carefully and consult with a doctor, wrote Swedish researcher Dr. Torbjorn Tomson, in an editorial that accompanied the new study.

Switching drugs after a woman realizes she is pregnant is unlikely to reduce the risk of birth defects. And abruptly stopping he medication may endanger the mother and the fetus, he wrote.

"That could be catastrophic," Meador agreed.

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2009-04-20 01:25 浏览 : 958 回复 : 5

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本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。

2009-04-20 07:55

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初译：Epilepsy drug in pregnancy may lower child's IQ
孕期服用抗癫痫药可能会降低孩子智商
http://www.washingtonpost.com/wp-dyn/content/article/2009/04/15/AR2009041502671.html
By MIKE STOBBE
The Associated Press （美联社）
Wednesday, April 15, 2009; 5:00 PM

ATLANTA -- Toddlers of moms who took the epilepsy drug valproate during pregnancy had lower IQs than the children of women who used other anti-seizure medicines, according to a new study.
亚特兰大—根据一项新的研究，怀孕期间服用丙戊酸盐抗癫痫药的妈妈生的幼儿比服用其它抗癫痫药的女性生的孩子智商要低。
The valproate children had IQ scores six to nine points lower by age 3, said the study's lead author, Dr. Kimford Meador of Emory University. The drug, also sold in the U.S. under the brand name Depakote, had previously been linked to birth defects, particularly spina bifida. Women of childbearing age have long been advised to avoid it.
该研究的主要作者，Emory 大学的Kimford Meador医生说丙戊酸盐小孩3岁时的智商要低6-9分。在美国这种药物也被以商标名双丙戊酸钠来卖，以前它和出生缺陷病有关系，特别是脊柱裂。育龄期女性被告知长期避免这种药物。
"We've known this drug is a bad actor for a long time," said Dr. Lewis Holmes, director of the North American Antiepileptic Disease Pregnancy Registry, based at Massachusetts General Hospital in Boston.
位于波士顿马萨诸塞州总医院的北美抗癫痫病妊娠登记处的主任Lewis Holmes医生说：“我们知道这种药物是一个不好的作用物已经好长时间了。”
The new study is important because it's the largest to show a connection between valproate and diminished IQ. Its publication in the prestigious New England Journal of Medicine should alert physicians who until now have ignored the drug's potential dangers to fetuses, added Holmes, who was not involved with the study.
Holmes 没有参加这项研究。他补充说：”这项新研究是重要的，因为它是显示丙戊酸盐和智商减退之间有联系的最大的研究。它在声望很高的新英格兰医学杂志上的发表应该引起那些直到现在还忽视这种药物对胎儿潜在危害的内科医生的注意。“
In the United States, about 25,000 children are born each year to women who have epilepsy, a brain disorder that causes people to have recurring seizures. In the study, researchers followed pregnant women in the United States and United Kingdom between 1999 and 2004. The results are based on about 260 of their children.
在美国每年大约有25，000个孩子是患癫痫（一种大脑紊乱，引起癫痫的反复发作）女性所生。在这项研究，研究人员随访了1999-2004年美国和英国的妊娠妇女。结果是260个孩子有智商减退。Toddlers whose mothers had taken valproate had IQs of 92, on average. In contrast, IQ scores were in the range of 98 to 101 for children of women who had taken lamotrigine, phenytoin, and carbamazepine. IQ tests are designed so a child of average intelligence scores 100.
服用丙戊酸盐母亲所生的幼儿智商平均在92分。与此相反，服用拉莫三嗪，本妥英和卡马西平的女性所生的孩子的智商在98-101分。智商测试被设计为小孩的平均智力得分为100分。
The higher the dosage of valproate a woman had taken, the lower the IQ of the child, the researchers found. For the other drugs, dosage levels made no significant difference.
研究人员发现：女性服用丙戊酸盐的剂量越高，小孩的智商越低。对于其它药物，剂量水平没有造成显著的区别。
The number of children in the study is small, and it's possible that other factors influenced the results. However, the researchers accounted for differences in a child's birth weight, the age and IQs of their mothers, the type of epilepsy the mothers had, and other factors that could have influenced the results.
该研究的小孩数量少，也有可能是其它因素影响了结果。但是研究人员说明了关于小孩出生体重、母亲年龄和智商、母亲患癫痫的类型和其它可能影响结果的因素的区别。
A major drawback is that the study did not include children whose epileptic mothers took no medication during pregnancy, Holmes said.
Holmes说：”一个主要的缺陷是这项研究没包括，妊娠期间没有服用抗癫痫药物的癫痫母亲所生的孩子。“
It's possible that all four epilepsy medications had some effect on mental development, he said. Without such a comparison group, it's hard to know, said Holmes, who is also a professor of pediatrics at Harvard Medical School.
他说所有四种抗癫痫药物都会对智力发展产生影响的说法是可能的。Holmes也是哈佛大学医学院的儿科教授，说：”但是没有这样的一个对照组，很难知道结果。”
Valproate, also given for migraine headaches and mood disorders, continues to be used by some epileptics because it's the only thing that works, said Meador, the study author.
该研究的作者Meador说:“也被用于治疗偏头痛和心境障碍的丙戊酸盐被一些专家继续使用，因为它是唯一起效的药物。”
Doctors say it's often important for epileptic women to keep taking their medications during pregnancy because seizures can lead to injuries.
医生说对癫痫女性在妊娠期间继续服用抗癫痫药物是很重要的，因为癫痫发作可以导致损伤。
Women on the drug who want to get pregnant should plan their pregnancies carefully and consult with a doctor, wrote Swedish researcher Dr. Torbjorn Tomson, in an editorial that accompanied the new study.
瑞典的研究者Torbjorn Tomson医生在与这项新研究有关的社论中写到：服用这种药物的且想要怀孕的女性应该小心计划她们的妊娠并请教医生。
Switching drugs after a woman realizes she is pregnant is unlikely to reduce the risk of birth defects. And abruptly stopping he medication may endanger the mother and the fetus, he wrote.
他写到：当一位女性在意识到她正在妊娠后转换药物也不可能降低出生缺陷病的风险。突然停药也许会危害到母亲和胎儿。
"That could be catastrophic," Meador agreed.
Meador也同意:”那会是灾难性的。“

2009-04-21 15:14

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编译：孕期服用抗癫痫药可能会降低孩子智商
亚特兰大—根据一项新的研究，怀孕期间服用丙戊酸盐抗癫痫药的妈妈生的幼儿比服用其它抗癫痫药的女性生的孩子智商要低。该研究的主要作者，Emory 大学的Kimford Meador医生说丙戊酸盐小孩3岁时的智商要低6-9分。在美国这种药物也被以商标名双丙戊酸钠来卖，以前它和出生缺陷病有关系，特别是脊柱裂。育龄期女性被告知长期避免这种药物。位于波士顿马萨诸塞州总医院的北美抗癫痫病妊娠登记处的主任Lewis Holmes医生说：“我们知道这种药物是一个不好的作用物已经好长时间了。”Holmes 没有参加这项研究。他补充说：”这项新研究是重要的，因为它是显示丙戊酸盐和智商减退之间有联系的最大的研究。它在声望很高的新英格兰医学杂志上的发表应该引起那些直到现在还忽视这种药物对胎儿潜在危害的内科医生的注意。“在美国每年大约有25，000个孩子是患癫痫（一种大脑紊乱，引起癫痫的反复发作）女性所生。在这项研究，研究人员随访了1999-2004年美国和英国的妊娠妇女。结果是260个孩子有智商减退。服用丙戊酸盐母亲所生的幼儿智商平均在92分。与此相反，服用拉莫三嗪，本妥英和卡马西平的女性所生的孩子的智商在98-101分。智商测试被设计为小孩的平均智力得分为100分。研究人员发现：女性服用丙戊酸盐的剂量越高，小孩的智商越低。对于其它药物，剂量水平没有造成显著的区别。该研究的小孩数量少，也有可能是其它因素影响了结果。但是研究人员说明了关于小孩出生体重、母亲年龄和智商、母亲患癫痫的类型和其它可能影响结果的因素的区别。Holmes说：”一个主要的缺陷是这项研究没包括，妊娠期间没有服用抗癫痫药物的癫痫母亲所生的孩子。“他说所有四种抗癫痫药物都会对智力发展产生影响的说法是可能的。Holmes也是哈佛大学医学院的儿科教授，说：”但是没有这样的一个对照组，很难知道结果。”该研究的作者Meador说:“也被用于治疗偏头痛和心境障碍的丙戊酸盐被一些专家继续使用，因为它是唯一起效的药物。”医生说对癫痫女性在妊娠期间继续服用抗癫痫药物是很重要的，因为癫痫发作可以导致损伤。瑞典的研究者Torbjorn Tomson医生在与这项新研究有关的社论中写到：服用这种药物的且想要怀孕的女性应该小心计划她们的妊娠并请教医生。他写到：当一位女性在意识到她正在妊娠后转换药物也不可能降低出生缺陷病的风险。突然停药也许会危害到母亲和胎儿。Meador也同意:”那种做法会是灾难性的。“

2009-04-21 15:20

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