In Utero Oxcarbazepine and a Withdrawal Syndrome, Anomalies, and Hyponatremia

Rolnitsky, Asaph; Merlob, Paul; Klinger, G

doi:10.1016/j.pediatrneurol.2013.02.012

Cited by 15 publications

(13 citation statements)

References 11 publications

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“…Previous studies had focused on MCMs of AEDs in pregnancy and cognitive function after fetal exposure to AEDs. It is noteworthy that there were recent case reports of neonatal abstinence syndrome (NAS) for in utero exposure to carbamazepine (Passia et al, 2017), oxcarbazepine (Chen et al, 2017a; Rolnitsky, Merlob & Klinger, 2013), and gabapentin (Carrasco et al, 2015). NAS was most frequent after in utero exposure to opioids, while recent studies showed that exposure to AEDs during pregnancy may induce NAS.…”

Section: Discussionmentioning

confidence: 99%

Emerging trends and knowledge structure of epilepsy during pregnancy research for 2000–2018: a bibliometric analysis

Wang¹,

Li²,

Tao³

et al. 2019

PeerJ

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Background Epilepsy during pregnancy presents a unique set of challenges for pregnant women, the fetus, and the health care community. As research in this area advances rapidly, it is critical to keep up with the emerging trends and key turning points of the development of the domain knowledge. This study aimed to construct a series of science maps to quantitatively and qualitatively evaluate the intellectual landscape and research frontiers in the field of epilepsy during pregnancy research. Methods All publications were extracted from the Web of Science Core Collection database. Bibliometric analysis was used to analyze the scientific research outputs, including journals, countries/regions, institutions, authors (cited authors), intellectual base and research hotspots. Results A total of 2,225 publications related to epilepsy during pregnancy were identified as published between 2000 and 2018. The overall trend of the number of publications showed a fluctuating growth from 59 articles in 2000 to 198 in 2018. Neurology was the leading journal in the field of epilepsy and pregnancy research both in terms of impact factor score (8.055) and H-index value (77). The US retained its leading position and exerted a pivotal influence in this area. The University of Melbourne was identified as a good research institution for research collaboration. Prof. Pennell and Tomson have made great achievements in this area, and Prof. Tomson laid a foundation for the development of this domain. The keyword “neonatal seizures” ranked first in research hotspots, and the keyword “autism spectrum disorders (ASD)” ranked first in research frontiers. Conclusions Epilepsy during pregnancy is a fascinating and rapid development of subject matter. A more recent emerging trend focused on comprehensive management of pregnant and lactating women, evaluation of the safety and efficacy of newer antiepileptic drugs. The keywords “management issue,” “brain injury,” “meta-analysis,” “in utero exposure,” and “ASD” were the latest research frontiers and should be closely observed.

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Section: Discussionmentioning

confidence: 99%

Emerging trends and knowledge structure of epilepsy during pregnancy research for 2000–2018: a bibliometric analysis

Wang¹,

Li²,

Tao³

et al. 2019

PeerJ

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“…To our knowledge, this is the second case report of an infant developing NAS following in utero oxcarbazepine exposure. In the first reported case of NAS induced by oxcarbazepine, the infant was born to a mother in status epilepticus who was treated with oxcarbazepine 1400 mg/day as monotherapy. Clinical signs of NAS occurred on the third day of life, peaked on day 7, and normalized by day 12 without any treatment other than supportive therapy.…”

Section: Discussionmentioning

confidence: 99%

In Utero Oxcarbazepine Exposure and Neonatal Abstinence Syndrome: Case Report and Brief Review of the Literature

Chen

et al. 2017

Pharmacotherapy

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Oxcarbazepine is a second‐generation antiepileptic drug that is used to treat partial seizures. Although it has been increasingly used in pregnant women, its fetal safety has not been fully validated. We describe a 12‐hour‐old neonate who developed neonatal abstinence syndrome (NAS) after intrauterine exposure to oxcarbazepine. The neonate was born via cesarean section to a mother who took oxcarbazepine 300 mg/day for treatment of seizures throughout her pregnancy. Approximately 12 hours after birth, the infant developed paroxysmal jitter, which mainly presented as increased excitability, irritability, limb shaking, and increased muscle tone. These symptoms resolved by day 9 of life. Although NAS occurs most often after in utero exposure to opioids, exposure to other drugs during pregnancy may contribute to a small proportion of NAS cases. To our knowledge, this is the second case report of oxcarbazepine‐induced NAS. Pregnant women with epilepsy should weigh the pros and cons of continuing oxcarbazepine during their pregnancy when they are prescribed this drug. For infants with in utero oxcarbazepine exposure, comprehensive assessments and examinations are necessary for screening oxcarbazepine‐induced NAS.

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“…A withdrawal syndrome was recently reported with oxcarbazepine, a structural derivative of CBZ, in an infant born at 35 weeks’ gestation by urgent cesarean section to a mother in status epilepticus who had been treated with oxcarbazepine throughout her pregnancy (Rolnitsky et al, 2013). On the third day of life the infant developed clinical signs of a withdrawal syndrome, which peaked at day 7 and resolved by day 12.…”

Section: Discussionmentioning

confidence: 99%

“Late” Withdrawal Syndrome after Carbamazepine In Utero Exposure in a CYP2C9 Slow Metabolizer Newborn

et al. 2017

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We report a case of carbamazepine withdrawal syndrome following in utero exposure to carbamazepine related to a pharmacogenetic predisposition factor. The infant was born at 37 1/7 weeks’ gestation by cesarean section to a mother treated for epilepsy with carbamazepine. One hour and thirty minutes after birth, the infant presented a respiratory distress with severe oxygen desaturation requiring intubation 5 h after birth. On the third day of life the infant developed clinical signs of a withdrawal syndrome which resolved progressively after 16 days and symptomatic treatment. The infant genotype analysis showed two low activity CYP2C9 allelic variants (∗2/∗3 heterozygote) predicting a CYP2C9 slow metabolizer phenotype which could explain reduced carbamazepine elimination and a late and long-lasting withdrawal symptoms observed 3 days after birth. The association of a withdrawal syndrome with carbamazepine exposure has not been previously reported and pharmacogenetic tests might therefore be useful in identifying patients at risk.

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In Utero Oxcarbazepine and a Withdrawal Syndrome, Anomalies, and Hyponatremia

Cited by 15 publications

References 11 publications

Emerging trends and knowledge structure of epilepsy during pregnancy research for 2000–2018: a bibliometric analysis

Emerging trends and knowledge structure of epilepsy during pregnancy research for 2000–2018: a bibliometric analysis

In Utero Oxcarbazepine Exposure and Neonatal Abstinence Syndrome: Case Report and Brief Review of the Literature

“Late” Withdrawal Syndrome after Carbamazepine In Utero Exposure in a CYP2C9 Slow Metabolizer Newborn

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