TY - JOUR T1 -青少年产前卡马西平暴露与学习成绩JF -神经学JO -神经学SP - e728 LP - e738 DO - 10.1212/WNL.00000000002半岛投注体育官网01529VL - 100 IS - 7 AU - Tai Ren AU - Priscilla Ming Yi Lee AU - Fei Li AU - Jiong Li Y1 - 2023/02/14 UR - http://n.半岛投注体育官网neurology.org/content/100/7/e728.abstract N2 -背景与目的研究怀孕期间使用卡马西平的母亲所生的孩子在青春期的学习成绩是否更差。这项以人口为基础的队列研究包括1996年至2002年丹麦所有参加国家九年级毕业考试的活出生的独生子女(n = 370,859)。排除孕妇在怀孕期间服用卡马西平以外的抗癫痫药物。我们研究了怀孕期间母体卡马西平在子宫内的暴露(n = 290)与后代学业成绩的关系，由九年级毕业考试的丹麦语和数学成绩定义。我们用线性回归估计了经社会经济因素和潜在适应症(包括癫痫和其他精神疾病的药物治疗)调整后的平均z-score差值。针对适应症混淆的其他分析包括子宫内暴露与过去暴露以及过去暴露与从未暴露之间的比较。宫内暴露于丙戊酸单药治疗作为阳性对照，宫内暴露于拉莫三嗪作为阴性对照。结果:在16.1岁(SD 0.4)岁时，宫内接受母体卡马西平单药治疗的青少年在九年级退学考试中的丹麦语和数学成绩均较低(调整后的z分差分别为−0.14 [95% CI−0.24至−0.05]和−0.17 [95% CI−0.28至−0.07])。宫内接受卡马西平单药治疗的儿童得分低于仅接受卡马西平治疗的儿童得分(校正后的z分数差为:丹麦儿童- 0.24 [95% CI - 0.41至- 0.06]，数学儿童- 0.25 [95% CI - 0.44至- 0.06])，而过去接受卡马西平治疗的儿童学业成绩略有下降(校正后的z分数差为:丹麦儿童- 0.02 [95% CI - 0.09至0.06]，数学儿童- 0.07 [95% CI - 0.16至0.01])。在子宫内暴露于丙戊酸单药治疗也观察到这种关联，但在子宫内暴露于拉莫三嗪没有。Discussion In utero exposure to carbamazepine was associated with poorer academic performance in adolescence, as represented by lower scores in ninth-grade exit examination in Danish and mathematics. Additional studies are needed to confirm these findings because of limitations in this study and variable findings in prior studies.Classification of Evidence This study provides Class III evidence that academic performance, as reflected in ninth-grade exit examinations in Danish and mathematics, was worse among those exposed to carbamazepine monotherapy in utero, compared with those without in utero exposure to antiseizure medications.ADHD=attention deficit and hyperactivity disorder; ASMs=antiseizure medications; ATC=Anatomical Therapeutical Chemical; HLA=human leukocyte antigen; ICD=International Classification of Diseases; LMP=last menstrual period ER -