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Adverse fetal and neonatal outcomes following in‐utero exposure to oxcarbazepine: A systematic review and meta‐analysis
Author(s) -
Athar Farwa,
Ehsan Muhammad,
Farooq Minaam,
Lo Kevin B.,
Cheema Huzaifa A.,
Ahmad Shahzaib,
Naveed Aiman,
Umer Mohammad
Publication year - 2022
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1111/bcp.15413
Subject(s) - oxcarbazepine , in utero , medicine , meta analysis , adverse effect , fetus , obstetrics , pregnancy , pharmacology , epilepsy , psychiatry , biology , carbamazepine , genetics
Aim This systematic review aims to assess the safety profile of oxcarbazepine during pregnancy. Methods Observational studies that included women who took oxcarbazepine anytime during pregnancy were included in our systematic review. The review did not include non‐English articles, reviews, meta‐analyses, case reports and animal studies. Different online sources such as MEDLINE, Cochrane library, Virtual Health Library, etc., were searched for published and unpublished literature. Assessment of the risk of bias in observational studies was carried out using the Newcastle‐Ottawa Scale. The meta‐analyses were performed using a random‐effect model. GRADE was used for the evaluation of the quality of evidence for the primary outcomes. Results We included 19 cohort studies with a total of 5 071 137 patients, of which 2450 were exposed to oxcarbazepine either as monotherapy or polytherapy. The summary odds ratio (OR) was 1.69 (95% CI, 0.95–2.98) for congenital malformations following in‐utero exposure to oxcarbazepine as compared to the control group of unexposed patients (seven studies [ n = 625]), and was 1.19 (95% CI, 0.67–2.12) when compared to those following lamotrigine (LTG) exposure during pregnancy (3 studies [ n = 591]). In total, three studies ( n = 770) reported the association between in‐utero oxcarbazepine exposure and fetal/perinatal deaths. The meta‐analysis yielded a summary OR of 3.33 (95% CI, 1.70–6.51). Conclusion Our systematic review will help healthcare providers and guideline developers regarding the treatment of epilepsy and other neurological disorders during pregnancy. More cohort studies with a higher sample size concerning oxcarbazepine use in pregnant patients are required to truly assess the in‐utero safety profile of the drug.