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\begin{document}

\title{Adverse Fetal and Neonatal Outcomes following in-utero exposure to
Oxcarbazepine: A Systematic Review and Meta-Analysis.}



\author[1]{Farwa Athar}%
\author[1]{Muhammad Ehsan}%
\author[1]{Minaam Farooq}%
\author[2]{Kevin Lo}%
\author[1]{Huzaifa Cheema}%
\author[1]{Shahzaib Ahmad}%
\author[1]{Aiman Naveed}%
\author[1]{Muhammad Umer}%
\affil[1]{King Edward Medical University}%
\affil[2]{Albert Einstein Medical Center Philadelphia}%


\vspace{-1em}



  
  \date{June 17, 2024}


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\begin{abstract}
\textbf{Aim}: This systematic review aims to assess the safety profile
of oxcarbazepine during pregnancy. \textbf{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unpublished literature.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 done 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.
\textbf{Results:} We included 19 cohort studies with a total number of
5,071,137 patients, of which 2,450 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). \textbf{Significance:} 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.%
\end{abstract}%



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