Brief report: Metabolic acidosis in newborn infants following maternal use of acetazolamide during pregnancy

Abstract

The information regarding fetal effects of acetazolamide use during pregnancy and lactation is sparse. We report the clinical and pharmacodynamic characteristics of maternal acetazolamide use and the timing of its effects on acid-base balance in three cases who presented with metabolic acidosis in the newborn period. We found that the infants’ clinical status soon after birth was inconsistently correlated with maternal drug dose and concentrations of medication in maternal serum. However, there was low transfer of the drug in breast milk and its use did not affect clinical symptomatology. We also present a review of literature on this subject to help consolidate our current knowledge on this topic.

Surgical Management of Idiopathic Intracranial Hypertension in Pregnancy

“…A second more recent case of ectrodactyly, ectodermal dysplasia, and cleft palate syndrome diagnosed at birth in the setting of maternal acetazolamide use (1,000 mg/day) for IIH has also been reported. Some reports of neonatal metabolic acidosis have also been reported (14). As a result of these patients, some suggest avoiding acetazolamide during the first 20 weeks of gestation, but other authors are less convinced, and no clear consensus guideline exists (8,15).…”

Tratamiento del glaucoma en el embarazo y lactancia: revisión de la literatura

“…En la Tabla 4 se resume la detección en leche materna, características, efectos adversos seguridad y recomendaciones acerca de los medicamentos para glaucoma en la lactancia (7,25,(51)(52)(53)(54)(55)(56)(57)(58)(59)(60)(61)(62)(63)(64).…”

“…Se ha detectado timolol en leche materna. Sin embargo, los niveles son tan bajos que no causan alteraciones en un lactante sano (54). Por tal motivo, este medicamento fue aprobado por la academia americana de pediatría para su uso durante la lactancia (55).…”

Management of idiopathic intracranial hypertension in pregnancy

“…40 Neonatal metabolic acidosis can occur following exposure in the third trimester. 41 Acetazolamide is considered safe at doses up to 1 g daily in breastfeeding mothers: the drug transfers to breastmilk in small quantities with neonatal exposure being less than 1% of the maternal dose per kilogram. 42,43…”