title: In utero oxcarbazepine and a withdrawal syndrome, anomalies, and hyponatremia.
abstract: Oxcarbazepine is an antiepileptic agent that has been used during pregnancy, although its safety during pregnancy has not been sufficiently established. This article presents an infant born with renal and cardiac malformations who developed a withdrawal syndrome and hyponatremia following in utero exposure to oxcarbazepine. The infant was born at 35 weeks' gestation by urgent cesarean section to a mother in status epilepticus who had been treated with oxcarbazepine throughout her pregnancy. Evaluation for congenital anomalies identified mild aortic stenosis, a bicuspid aortic valve, patent foramen ovale, patent ductus arteriosus, and severe left hydronephrosis due to left ureteropelvic junction stenosis. On the third day of life the infant developed clinical signs of a withdrawal syndrome, which peaked on day 7 and resolved by day 12. Transient hyponatremia resolved by day 8 of life. Follow-up showed normal development at 15 months. The association of a withdrawal syndrome with oxcarbazepine exposure has not been previously reported. The hyponatremia is consistent with adult reports. The possible association of oxcarbazepine with renal and cardiac malformations requires further confirmation.
authors.affiliation: Neonatology Department, Schneider Children's Medical Center of Israel, Petah Tikva, Israel.
authors.forename: Asaph
authors.initials: A
authors.lastname: Rolnitsky
authors.forename: Paul
authors.initials: P
authors.lastname: Merlob
authors.forename: Gil
authors.initials: G
authors.lastname: Klinger
mesh_terms: D000927:Anticonvulsants / Q000009:adverse effects*; D002220:Carbamazepine / Q000009:adverse effects / Q000031:analogs & derivatives*; D004827:Epilepsy / Q000188:drug therapy; D005260:Female; D006801:Humans; D007010:Hyponatremia / Q000139:chemically induced*; D007223:Infant; D000078330:Oxcarbazepine; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000503:physiopathology*; D013375:Substance Withdrawal Syndrome / Q000209:etiology*; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D002220:Carbamazepine; D000078330:Oxcarbazepine