Global Trends in Pharmacokinetic Changes During Pregnancy: A Bibliometric and Thematic Analysis of Articles Indexed in Scopus (1971-2025)

Global Trends in Pharmacokinetic Changes During Pregnancy: A Bibliometric and Thematic Analysis of Articles Indexed in Scopus (1971-2025) | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Systematic Review Global Trends in Pharmacokinetic Changes During Pregnancy: A Bibliometric and Thematic Analysis of Articles Indexed in Scopus (1971-2025) Mohammed Jalal, Riad Mohammed Abdelrahman, Taha Hussein Musa, and 5 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7965704/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Physiological changes during pregnancy significantly alter drug pharmacokinetics, yet research remains limited due to ethical and methodological challenges. A consolidated overview of the most influential studies is lacking. Objective This study aimed to perform a comprehensive bibliometric and thematic analysis of global research on pharmacokinetic changes during pregnancy from 1971 to 2025, identifying trends, influential contributors, emerging themes, and knowledge gaps. Methods A bibliometric analysis was conducted on October 8th, 2025 using data extracted from the Scopus database for publications between 1971 and 2025. Performance indicators were analyzed using descriptive statistics and correlation analyses. Bibliometrix (R), VOS viewer, and GraphPad Prism were used for bibliometric mapping, co-authorship networks, and thematic clustering. Results A total of 1,391 publications by 8,192 authors across 511 journals were identified, showing an annual growth rate of 6.18% and 18.89% international collaboration. The United States (13%), Italy (5%), and New Zealand (4%) were leading contributors. Clinical Pharmacokinetics was the top journal, while the "University of Washington, Seattle, united states" and "Wolters Kluwer health - Adis, Auckland, New Zealand”, were the most influential institutions. Core keywords included “pregnancy,” “pharmacokinetics,” “HIV,” “epilepsy,” and “therapeutic drug monitoring,” with emerging themes such as “metabolism” and “controlled study.” Thematic evolution revealed a shift from methodological foundations (1971–1988) to clinical applications (1989–2015) and mechanistic approaches (2016–2025). Conclusions Global research on pharmacokinetic changes during pregnancy has grown steadily, transitioning toward model-informed and mechanistic studies. However, the absence of mature motor themes indicates thematic fragmentation. Strengthening international collaboration, advancing physiologically based pharmacokinetic modeling, and expanding studies across diverse populations and drug classes remain priorities to optimize pharmacotherapy in pregnancy. Pharmacokinetics Pharmacokinetics Pregnancy Scopus Bibliometrics Drug absorption Drug distribution Drug metabolism Drug excretion PBPK Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 1. Introduction Physiological changes during pregnancy can significantly alter how drugs are absorbed, distributed, metabolized, and excreted, affecting their pharmacokinetics and pharmacodynamics. These changes may lead to either reduced or increased drug levels, potentially compromising treatment effectiveness or increasing the risk of adverse effects for both mother and fetus. ( 1 ) Despite this, optimal dosing in pregnancy is rarely studied, and pharmacokinetic changes for most medications remain poorly understood, making it unclear whether single or multiple dose adjustments are needed as pregnancy progresses.( 2 ) Pregnancy induces significant anatomical and physiological changes across multiple organ systems, which can impact drug pharmacokinetics. These include reduced gastrointestinal motility and higher gastric pH (affecting drug absorption), increased body water and plasma volume, and lower drug-binding protein levels (altering drug distribution and sometimes clearance) ( 3 ). Additionally, enhanced kidney function increases renal clearance, while liver enzyme activity changes affect drug metabolism. These physiological adjustments progress throughout pregnancy and generally peak in the third trimester, particularly changes in cardiac output, body water, fat stores, glomerular filtration rate, and plasma albumin levels ( 4 ). Despite its clinical importance, research on pharmacokinetics in pregnant women remains limited. Pregnant populations are often excluded from randomized controlled trials due to ethical and safety concerns, leaving clinicians to rely on small observational studies, extrapolations from nonpregnant adults, or post-marketing surveillance ( 5 ),( 6 ). Consequently, the available knowledge is fragmented, discipline-specific, and often underpowered to guide evidence-based prescribing in pregnancy. The scarcity of comprehensive data contributes to the ongoing problem of medication underuse, misuse, and avoidable adverse maternal-fetal outcomes. Pharmacokinetic clinical trials exist for certain drug classes during pregnancy. A review found that since 2008, roughly one-third of these studies focused on drugs for labor and delivery, another third on treatments for infectious diseases, and the rest on various antepartum conditions ( 7 ),( 8 ). Over 90% of pregnant individuals use at least one medication during pregnancy ( 9 ). However, for most medications used during pregnancy, data on pharmacokinetic changes and dosing requirements remain scarce. Furthermore, it is often unclear whether these pharmacokinetic changes affect drug efficacy or safety ( 10 ),( 11 ). The physiological adaptations required to support fetal development-such as increased blood volume, enhanced renal clearance, and altered hepatic enzyme activity-significantly affect drug absorption, distribution, metabolism, and excretion ( 7 ),( 12 ). Studying pharmacokinetics during pregnancy involves complex ethical challenges due to the need to protect both the mother and fetus while addressing a critical gap in medical knowledge ( 13 ). Key concerns include obtaining truly informed consent, minimizing fetal risk, and overcoming the historical exclusion of pregnant women from clinical trials, which limits safe treatment options. As a vulnerable population, pregnant individuals require additional protections to prevent exploitation ( 14 ). Ethical research must also consider potential long-term effects on the child, ensure diverse representation to improve generalizability, and comply with rigorous regulatory and ethical standards. Balancing the potential benefits of research with the risks involved remains a central moral dilemma ( 15 ). The thalidomide tragedy (1957–1961) significantly influenced ethical regulations and delayed direct studies in pregnant women for years. Thus, most pharmacokinetic insights prior to the 1960s were anecdotal or observational. Post-1960s, structured pharmacokinetic research began evolving, especially for drugs essential during pregnancy such as anticonvulsants, antimicrobials, and antiretrovirals ( 16 ). Pharmacokinetic research in pregnancy has grown substantially, initially focusing on essential drugs like antiepileptics, antibiotics, and antiretrovirals, then expanding to cardiovascular drugs, antidepressants, immunosuppressants, and biologics ( 12 ). Studies have progressed from small observational designs to larger controlled and multicenter trials, incorporating advanced modeling approaches like population pharmacokinetics and physiologically based pharmacokinetic (PBPK) modeling ( 17 ). Recent research increasingly evaluates not only maternal pharmacokinetics but also placental drug transfer and fetal drug exposure to better understand safety profiles ( 18 ). One of the earliest substantial pharmacokinetic studies in pregnant women was a prospective investigation by Lander et al. (1977), which examined plasma levels of antiepileptic drugs, including phenytoin, throughout pregnancy. They observed a significant reduction in circulating drug levels despite constant dosing, indicating increased drug clearance during pregnancy. Their findings reinforced the need for therapeutic drug monitoring and dosage adjustments in pregnant patients to maintain efficacy and safety ( 19 ). Literature on pharmacokinetics during pregnancy is dispersed across multiple disciplines, including clinical pharmacology, obstetrics, pediatrics, maternal–fetal medicine, and toxicology. Most existing studies are quantitative in nature, whereas qualitative investigations remain scarce. Consequently, no comprehensive overview currently exists to map influential research trends, thematic directions, or knowledge gaps in this field. In recent years, bibliometrics has gained significant attention as a method for swiftly analyzing scientific outputs both quantitatively and qualitatively. It serves as a crucial tool for evaluating the volume and impact of publications, such as journal articles and books ( 20 ). Visual analysis of the knowledge structure and emerging research hotspots within a specific field has proven effective in highlighting research progress and technological advancements. It also offers a theoretical basis and guidance for future investigations in the area ( 21 ). While bibliometric analysis has its limitations-such as the inability to assess research quality and its dependence on data source selection-it remains a valuable tool for identifying research trends and guiding future studies. However, it should be used alongside other methods like content analysis for a more comprehensive evaluation ( 22 ). This study aimed to perform a bibliometric and thematic analysis of the global articles on pharmacokinetic changes during pregnancy, indexed in the Scopus database from 1971 to 2025. By choosing this duration, we aimed to show the historical evolution of research. The longer period increases heterogeneity in study design and methodology, which may affect thematic analysis but is valuable for a comprehensive global overview. However, for bibliometrics, older studies tend to have more citations, so we used citation/year normalization to avoid skewing results toward the oldest studies. Specifically, this work sought to map publication and citation patterns, identify key authors, journals, institutions, and countries contributing to this field, categorize major thematic areas addressed in highly cited literature; and highlight persistent knowledge gaps to inform future research and clinical practice. 2. Materials and Methods 2.1. Sources of data This study aimed to conduct a Bibliometric and Thematic Analysis of the globally cited publications in Pharmacokinetic Changes During Pregnancy. Metadata extracted for exploring the articles in Pharmacokinetic Changes During Pregnancy from 1971 to 2025 via the Scopus database ( https://www.scopus.com/ ). The Scopus database is a platform that provides a unique advanced search world’s most trusted citation index for scientific and scholarly research and is used to provide researchers with a comprehensive dataset used subsequently for bibliometric analysis across many disciplines. On October 8th, 2025, we searched the Scopus database for articles on Pharmacokinetic Changes During Pregnancy published in peer-reviewed journals. A flowchart of the article screening process is shown in Fig. 1. A Boolean search process includes the following subject term search formula: TITLE-ABS-KEY in Scopus databases related to spatial Pharmacokinetic Changes During Pregnancy: ((TITLE-ABS-KEY(Pharmacokinetics) AND TITLE-ABS-KEY(Pregnancy OR Pregnant) AND TITLE-ABS-KEY(Changes)) AND PUBYEAR > 1970 AND PUBYEAR < 2026 AND ( LIMIT-TO ( EXACTKEYWORD,"Pregnancy" ) OR LIMIT-TO ( EXACTKEYWORD,"Pharmacokinetics" ) OR LIMIT-TO ( EXACTKEYWORD,"Drug Metabolism" ) OR LIMIT-TO ( EXACTKEYWORD,"Pregnant Woman" ) OR LIMIT-TO ( EXACTKEYWORD,"Drug Clearance" ) OR LIMIT-TO ( EXACTKEYWORD,"Drug Distribution" ) OR LIMIT-TO ( EXACTKEYWORD,"Drug Absorption" ) OR LIMIT-TO ( EXACTKEYWORD,"Drug Elimination" ) OR LIMIT-TO ( EXACTKEYWORD,"Pharmacokinetic Parameters" ) OR LIMIT-TO ( EXACTKEYWORD,"Drug Disposition" ) OR LIMIT-TO ( EXACTKEYWORD,"Drug Bioavailability" ) OR LIMIT-TO ( EXACTKEYWORD,"Drug Excretion" ) ) AND ( LIMIT-TO ( DOCTYPE,"ar" ) OR LIMIT-TO ( DOCTYPE,"re" ) ) AND ( LIMIT-TO ( LANGUAGE,"English" ) ) ). The metadata on global Pharmacokinetic Changes During Pregnancy were extracted by the authors on October 8th, 2025, to avoid daily updating bias because the database is still open and the average number of citations can increase per day. The authors defined databases on the basis of their availability and data accessibility. The search records of global documents associated with Pharmacokinetic Changes During Pregnancy -indexed Scopus included 1391 documents after filtering by document type (review OR article) and language (English). The search was performed and the Scopus database was collected and exported in RIS, BibTeX, and CSV formats. 2.2. Inclusion and Exclusion Criteria An overall document of Pharmacokinetic Changes During Pregnancy -associated publications from the Scopus database was included in our analysis. The terms related with the Pharmacokinetic process were added as extra keywords. The exclusion criteria included all types of reported documents, such as (letters, notes, conference papers, short surveys, editorials, book chapters, errata, early access, proceedings papers, and undefined) publications, which were excluded from Scopus). Moreover, other non-English records were excluded. 2.3. Bibliometric Analysis Descriptive statistical analyses of the key metadata, time series of publications, sources of local impact, author impact analysis, leading institutions, leading countries, and publication performance were performed via the Bibliometrix tool in R for Windows. VOS viewer ( 23 ),( 24 ) software was used for visual analysis of co-authorship networks, co-occurrence of reported keywords, and citation and co-citation maps based on bibliographic data. Thematic map visualization and evaluation were conducted via Bibliometrix to carry out conceptual network analysis, factorial analysis, social network analysis, and collaboration network analysis, whereas country collaboration maps were analyzed via R Studio version 4.4.3 software, Bibliometrix, the R package, and an online analysis platform. GraphPad Prism 9 (version 9.2.0, GraphPad Software LLC, United States) and OriginPro 2019 v9.6 were used for inferential statistical analysis and to correlate study variables. A P value less than or equal to 0.05 was considered statistically significant. Additionally, autocorrelation analysis and citation/year normalization (citation windows) were applied to the time-series data to assess temporal dependencies and patterns in publication trends. 3. Results 3.1. Trends in global publication and main characteristics Figure 2 shows the descriptive summary statistical analysis of the 1391 identified global publications on Pharmacokinetic Changes During Pregnancy, including year, sources, annual growth, document contents, authors, and document types during the period of 1971–2025. The included articles and reviews published in 511 sources by 8192 authors, with only one single-author documents and 16.89% international co-authorships. The annual growth rate was 6.18%. 3.2. Performance analysis of in Pharmacokinetic Changes During Pregnancy -associated publications As illustrated in Fig. 3 , the evolution of Pharmacokinetic Changes During Pregnancy-related publications between 1971 and 2025 shows an initial steady rise in scientific output up to 1986, followed by a consistent decline extending to 1999 to rise steadily again to reach a peak in 2024 (60 articles), start drop in 2025 (until October). Citation performance rise steadily from 1971, with the mean total citations per article (MeanTCperArt) reaching a peak of 8 in 2005, then fluctuate before reach a bottom in 2025. These results indicate that years with greater publication counts did not necessarily correspond to higher citation rates per year, though after 2000, periods of higher output were modestly associated with improved citation averages per article. Correlation analyses demonstrated significant positive relationships among most bibliometric indicators. The number of articles showed a moderate positive correlation with mean total citations per article (r = 0.24, 95% CI [0.06–0.40], p < 0.001) and mean total citations per year (r = 0.17, 95% CI [0.00–0.33], p < 0.001). 3.3. Authorship analysis Table 1 Top 10 authors' local impact on Pharmacokinetic Changes During Pregnancy -associated publications from the Scopus database (1971–2025) on the basis of the h_index Author (n = 8,192) h_index g_index m_index TNC TNP PY_start Dam, M. 50 50 1 13116 50 1976 Voutilainen, R. 36 36 0.923 9189 36 1987 Crema, A. 35 35 0.795 9365 35 1982 Periyasamy, S. 28 28 0.651 6813 28 1983 Kellerman, D. 24 24 0.558 6051 24 1983 Levy, G. 21 21 0.457 5788 21 1980 Christiansen, J. 21 21 0.447 5256 21 1979 Lindberg, B. 18 18 0.439 4915 18 1985 McCormick, K. 16 16 0.444 3572 16 1990 Benfield, P. 16 16 0.4 4616 16 1986 Dam, M. 50 50 1 13116 50 1976 TNC, total number of citations; TNP, total number of publications; PY_start, publication year start. A total of 8,192 authors contributed to global research on Pharmacokinetic Changes During Pregnancy. Among the most influential contributors, Dam, M. achieved the highest h-index (50), followed by Voutilainen, R. (h-index = 36), as well as Crema, A. (h-index = 35) (Table 1 ). Collaboration measures showed consistent positive associations with impact indicators. Weak but significant correlations were observed between the number of coauthors and total citations (r = 0.16, 95% CI [0.00–0.31], p < 0.001), h-index (r = 0.16, 95% CI [0.00–0.31], p < 0.001), and g-index (r = 0.16, 95% CI [0.00–0.31], p < 0.001). Table 2 shows top 10 most cited documents on Pharmacokinetic Changes During Pregnancy -associated publications from the Scopus database Table 2 Top 10 most cited documents on Pharmacokinetic Changes During Pregnancy -associated publications from the Scopus database (1971–2025) Paper DOI Total Citations TNC per Year Grotenhermen, 2003, clin. pharmacokinet. 10.2165/00003088-200342040-00003 1193 51.87 Patsalos, 2008, Epilepsia 10.1111/j.1528-1167.2008 . 01561.x 1018 56.56 Soldin, 2009, clin. pharmacokinet. 10.2165/00003088-200948030-00001 883 51.94 Anderson, 2005, clin. pharmacokinet. 10.2165/00003088-200544100-00001 597 28.43 Cerbin-koczorowska, 2021, appl. sci. 10.3390/app11114905 570 114.00 Rosenberg, 2004, reg. anesth. pain med. 10.1016/j.rapm.2004.08.003 498 22.64 Shafer, 2005, environ. health perspect. 10.1289/ehp.7254 467 22.24 Davies, 2000, clin. pharmacokinet. 10.2165/00003088-200038030-00003 414 15.92 Chaffman, 1985, drugs 10.2165/00003495-198529050-00001 395 9.63 Dunn, 1995, drugs 10.2165/00003495-199549050-00007 388 12.52 3.4. Corresponding Author’s countries An analysis of global Pharmacokinetic Changes During Pregnancy publications revealed contributions from 84 countries, resulting in 18.89% international co-authorships (Table 3 and Fig. 2 ). Table 3 details the top ten countries contributing to Pharmacokinetic Changes During Pregnancy research productivity. The USA emerged as the most prolific contributor, with 184 publications (13%). Italy followed 70 publications (5%). Additionally, New Zealand ranked among the leading contributors, with 50 publications (4%). Table 3 Top 10 Corresponding Author’s Countries with higher production of documents on Pharmacokinetic Changes During Pregnancy from the Scopus database (1971–2025) Country(n = 84) TNP USA 184 Italy 70 New Zealand 50 Germany 45 Sweden 36 UK 35 Australia 29 Denmark 21 Norway 14 Spain 14 3.5. Top 10 journals published articles on Pharmacokinetic Changes During Pregnancy A total of 511 journals published the 1391 identified articles on Pharmacokinetic Changes During Pregnancy (Table 4 ). Clinical Pharmacokinetics ranked first, with 64 documents and 7334 total citations, followed by Drugs Journal (46 documents) and 5449 citations, and the American journal of obstetrics and gynecology (32 articles, 918 citations). Perfect correlations were found between the number of articles and both the h-index and g-index (r = 1.00, p < 0.001), reflecting mathematical dependence between these variables. A moderate positive association was found between the number of articles and m-index (r = 0.44, 95% CI [0.27–0.58], p < 0.001), while a strong correlation was observed between the number of articles and total citations (r = 0.61, 95% CI [0.47–0.72], p < 0.001). Autocorrelation diagnostics (Durbin–Watson ≈ 1.8–2.1) indicated no significant temporal dependence. When adjusted for citation windows, the 2-year metrics showed weaker correlations (r ≈ 0.15–0.25) compared with stronger and more stable 5-year windows (r ≈ 0.35–0.50), consistent with citation maturation effects. Table 4 Top 10 journals on Pharmacokinetic Changes During Pregnancy -associated publications from the Scopus database by the number of local citations h_index (1971–2025) Source (n = 511) h_index g_index m_index TNC TNP PY_start Clinical pharmacokinetics 41 64 0.82 7334 64 1976 Drugs 41 46 0.837 5449 46 1977 American journal of obstetrics and gynecology 19 30 0.365 918 32 1974 Clinical pharmacology and therapeutics 19 28 0.365 1690 28 1974 British journal of clinical pharmacology 16 27 0.32 887 27 1976 Endocrinology (united states) 16 25 0.302 1032 25 1973 Drug metabolism and disposition 14 29 0.275 900 32 1975 Journal of clinical pharmacology 14 24 0.35 620 32 1986 Epilepsia 13 17 0.317 2134 17 1985 European journal of clinical pharmacology 13 17 0.245 617 17 1973 TNC, total number of citations; TNP, total number of publications; PY_start, publication year start. 3.6. Analysis of the top 10 relevant affiliations or institution influence (1971–2025) A total of 1487 institutions were reported. Many scientific institutions have provided evidence that research institutions have played a crucial role in driving research productivity on Pharmacokinetic Changes During Pregnancy -associated publications from the Scopus database over the past 24 years. With 14 as a minimum number of publications for the institution,22 met criteria. university of Washington, Seattle, United States, had a greater influence on these institutions, with 56 articles with 3065 citations and 33 total link strengths. However, Wolters Kluwer health - Adis, Auckland, New Zealand, has the highest number of citations (4085) for only 35 articles, with a zero total link strength. (Table 5 ). Table 5 Analysis of the top 10 most institutional influences contributed by articles on Pharmacokinetic Changes During Pregnancy (1971–2025) No Institution (n = 1487) Documents Citations TLS 1. "University of Washington, Seattle, united states" 56 3065 33 2. "Wolters Kluwer health - Adis, Auckland, New Zealand" 35 4085 0 3. "Food and drug administration, silver spring, united states" 28 693 23 4. "University of Pittsburgh school of medicine, Pittsburgh, united states" 28 1003 37 5. "University of Liverpool, Liverpool, United Kingdom" 27 467 15 6. "Certara, United Kingdom, canterbury, United Kingdom" 26 1322 15 7. "National institute of child health and human development (nichd), Bethesda, united states" 22 1834 23 8. "Northwestern university Feinberg school of medicine, Chicago, united states" 22 564 12 9. "Boston university Chobani an & Avedisian school of medicine, Boston, united states" 20 540 26 10. "University of Pittsburgh, Pittsburgh, united states" 20 709 37 TLS; Total length strength 3.7. Keywords analysis According to the co-occurrence analysis shown in Table 6 and Fig. 4 via VOS viewer, the total number of identified author keywords was 2103, and the number of keywords plus was 10778. When analyzed the author keyword with minimum occurrence of 8 ; 34 met the criteria ; “pregnancy” appears 374 times with a total link strength (TLS) of 515, followed by “pharmacokinetics” with 283 occurrences and 443TLS, then “HIV" with 43 occurrences and 82 TLS, “epilepsy” occurs 40 times with 97 link strength, “pbpk” arriving approximately 38 times with 61 TLS, the keyword “therapeutic drug monitoring” occurs 27 times with 66 TLS (Fig. 4A). In the keyword plus analysis, with minimum occurrences of 170; 28 met the criteria, “pregnancy”, with 1267 occurrences have 9800 TLSs. The words indicate that “female” occurred in total in 1156, with 9349TLSs, and the words “human” occurred in 963, TLS 7299, in last the words “pharmacokinetics” occurred 885 with 6752TLS (Fig. 4B). Overlay visualization of the co-occurrence analysis of Keywords Plus over the years in Fig. 4C shows that new and emerging topics starting in 2010 concern the words “human,” “metabolism,” and “controlled study”. Figure 5 shows the word cloud of publications on pharmacokinetic changes during pregnancy (1971–2025). Table 6 Co-occurrence of keywords through VOS viewer Type Occurrences Total Link Strength Keyword (n = 2103) pregnancy 374 515 pharmacokinetics 283 443 hiv 43 82 epilepsy 40 97 pbpk 38 61 therapeutic drug monitoring 27 66 lactation 25 50 pharmacodynamics 24 52 placenta 22 35 postpartum 21 46 Keyword plus(n = 10778) pregnancy 1267 9800 female 1156 9349 human 963 7299 pharmacokinetics 885 6752 humans 641 5344 article 637 5528 priority journal 520 4588 adult 416 3538 nonhuman 395 3629 review 370 2717 3.8. Thematic analysis As shown in Fig. 6 A, the thematic mapping of the author keywords revealed distinct clusters across the four themes. Within the basic theme, core topics such as pregnancy, pharmacokinetics, HIV, epilepsy, therapeutic drug monitoring, lactation, pregnant women, and special populations were identified. These themes demonstrate high centrality, highlighting their importance and relevance to the broader field. However, their relatively low density suggests that, while foundational, these topics remain conceptually underdeveloped and continue to evolve as central areas of investigation. The niche theme included cancer, chemotherapy, treatment, children, drugs, nicotine, and antibiotics. These themes were characterized by high density but low centrality, indicating that they are well-developed within themselves but relatively isolated from the central knowledge structure of the field. Such themes represent specialized areas of study that contribute important but peripheral insights. In the emerging theme, progesterone, rat, and malaria were identified. Their position indicates that these topics are either losing prominence or are in the early stages of development, with limited integration into the wider research framework. These themes may represent areas requiring renewed focus to determine their future trajectory within the field. Notably, the motor theme, typically occupied by well-developed and highly relevant topics, was unpopulated. This absence suggests that no dominant, fully mature research theme currently drives the field, reflecting a lack of cohesive integration and signaling opportunities for further consolidation of knowledge. Figure 6 B illustrates the keyword plus thematic mapping. It revealed a concentration of themes across three quadrants. In the basic theme, the dominant concepts included pregnancy, female, and priority journal. Their high centrality underscores their importance to the structure of the field, serving as foundational areas of research. However, the low density of these clusters reflects their broad but underdeveloped nature, suggesting that while central to the discipline, further conceptual refinement is still needed. Within the niche theme, the cluster comprising human, humans, and article was identified. This theme demonstrated high density but low centrality, indicating it is internally well-developed yet somewhat isolated from the broader research network. Its strong cohesion points to a focused body of work, though with limited integration into the wider thematic structure. The emerging theme included pharmacokinetics, nonhuman, and animal. These themes exhibited both low density and centrality, implying that they are either losing relevance in the current research landscape or are underdeveloped areas that may warrant further exploration to establish their role in advancing the field. Notably, the motor theme remained unpopulated, indicating the absence of mature, well-integrated, and driving themes that could provide direction for future research. 3.9. Thematic evolution The thematic evolution analysis (Fig. 7 ) illustrates how research themes have shifted over time across three distinct periods (1971–1988, 1989–2015, and 2016–2025). During the earliest period (1971–1988), the focus was largely on broad methodological and experimental descriptors such as human, nonhuman, kinetics, and pharmacokinetics. These themes reflect the foundational stage of research, with emphasis on basic experimental models and pharmacokinetic principles. In the second phase (1989–2015), there was a clear transition toward more clinically relevant themes. The emergence of pregnancy as a central concept marked a significant shift, integrating earlier pharmacokinetic investigations into maternal health contexts. Additionally, epilepsy and human immunodeficiency virus (HIV) infection gained prominence, reflecting growing concern over therapeutic drug use in special populations during pregnancy. The theme article also appeared, suggesting increasing publication output and formalization of the field. In the most recent period (2016–2025), pregnancy has remained a dominant and persistent theme, demonstrating continuity and sustained centrality in the field. At the same time, new directions have emerged, particularly the appearance of metabolism, which indicates an increasing focus on mechanistic insights into drug disposition during pregnancy. This progression underscores a broadening of the research scope, moving from descriptive pharmacokinetics toward integrative approaches that link maternal physiology, therapeutic needs, and drug metabolism. 4. Discussion Various quantitative systematic reviews and meta-analyses have examined pharmacokinetic changes during pregnancy ( 1 ),( 25 ). However, to the best of our knowledge, no qualitative or bibliometric analysis has been conducted to explore research trends, thematic evolution, or collaboration networks in this field. The present study represents the first bibliometric analysis to visualize the global research landscape, identify emerging topics, and highlight influential authors, institutions, and collaborative clusters related to pharmacokinetic changes during pregnancy. This study also helps lay the groundwork for new or emerging aspects of the topic of pharmacokinetic changes during pregnancy research areas. This bibliometric analysis provides a comprehensive overview of global research trends on pharmacokinetic changes during pregnancy from 1971 to 2025. The observed steady rise in publications over the decades reflects the increasing recognition of pregnancy as a special pharmacological state requiring distinct therapeutic considerations. The annual growth rate of 6.18% aligns with bibliometric trends reported in maternal-fetal pharmacology and drug safety literature, indicating expanding interdisciplinary interest and regulatory attention to individualized drug therapy in pregnant women ( 26 ), ( 27 ). The correlation analyses revealed significant positive associations among key bibliometric indicators, suggesting that productivity and citation impact evolve in parallel across this research field. The moderate correlations between the number of articles and mean total citations per article (r = 0.24) or per year (r = 0.17) are consistent with earlier bibliometric findings in pharmacokinetic and clinical pharmacology domains, where publication volume modestly enhances visibility but not necessarily per-article impact ( 28 ), ( 29 ). Similarly, weak yet significant associations between the number of authors and impact indicators such as total citations and h-index (r = 0.16) highlight the collaborative but specialized nature of research in this area. Prior analyses suggest that collaboration fosters dissemination and quality through methodological diversity and international expertise ( 30 ), ( 31 ). The perfect correlations observed between the number of publications and both h- and g-indices (r = 1.00) are attributable to their structural dependence on publication count, consistent with earlier bibliometric validations ( 32 ). Meanwhile, the moderate correlation with the m-index (r = 0.44) indicates that sustained scholarly engagement over time remains an important determinant of influence, as the m-index accounts for career duration and temporal consistency ( 33 ).The strong correlation between publication count and total citations (r = 0.61) reinforces that long-term productivity translates to cumulative academic influence. Autocorrelation diagnostics (Durbin-Watson = 1.8–2.1) showed no significant non-independence, confirming statistical robustness and temporal stability in citation patterns. When citation windows were considered, weaker associations in 2-year windows compared to stronger and more stable 5-year correlations (r = 0.35–0.50) reflected the citation maturation phenomenon, as pharmacokinetic and clinical studies typically accumulate citations gradually due to extended validation and translational application timelines ( 34 ), ( 35 ). Institutional analysis revealed that the University of Washington and Wolters Kluwer Health–Adis emerged as dominant contributors in terms of both productivity and citation performance, consistent with their established leadership in pharmacokinetics, drug safety, and maternal health research. The keyword and thematic mapping highlighted “pregnancy,” “pharmacokinetics,” “PBPK modeling,” and “therapeutic drug monitoring” as recurring core terms, aligning with contemporary focus on model-informed precision dosing and physiologically based pharmacokinetic (PBPK) modeling ( 36 ), ( 37 ). Emerging topics such as “metabolism” and “controlled studies” suggest an ongoing shift toward translational pharmacology and real-world evidence generation in this population. Overall, these findings confirm that the field of pharmacokinetics during pregnancy is evolving from descriptive pharmacology toward data-driven, mechanistic, and computational modeling approaches, with increasing international collaboration and expanding scientific impact. Continued integration of bibliometric and scientometric methods-such as time-series modeling, autocorrelation analysis, and citation window standardization-will be critical to monitor future developments and identify influential research streams. The global landscape of research on Pharmacokinetic Changes During Pregnancy demonstrates active scientific engagement across 84 countries, reflecting the growing international recognition of this topic’s clinical and pharmacological significance. The analysis revealed an international co-authorship rate of 18.89%, indicating a moderate yet meaningful level of global collaboration. Such cross-border cooperation is essential for advancing pharmacokinetic research in pregnancy, as it allows for pooling of diverse clinical data, harmonization of analytical methods, and broader applicability of findings across different populations ( 38 ),( 39 ). The United States emerged as the most prolific contributor, accounting for 184 publications (13%) of the total research output. This predominance aligns with the U.S. leadership in biomedical research infrastructure and its extensive clinical trial ecosystem focused on maternal and fetal health. Italy ranked second with 70 publications (5%), reflecting Europe’s sustained contribution to pharmacological sciences and its active involvement in maternal pharmacotherapy studies. Notably, New Zealand, despite its smaller research base, ranked among the top contributors with 50 publications (4%), highlighting its emerging influence in pregnancy pharmacokinetics and maternal health research ( 40 ). The overall distribution of research output underscores a clear dominance of high-income countries in this domain, which is consistent with trends observed in other areas of clinical pharmacology. Limited participation from low- and middle-income countries (LMICs) may be attributed to restricted access to research funding, limited pharmacokinetic laboratory capacity, and underrepresentation in clinical studies involving pregnant populations ( 41 ). Strengthening collaborative research frameworks and capacity-building initiatives in LMICs could help bridge these disparities and promote a more globally representative understanding of pharmacokinetic changes during pregnancy. The observed 18.89% international co-authorship rate, while positive, suggests potential for further improvement in global scientific networking. Enhanced collaboration can lead to better data standardization, improve study reproducibility, and support the development of international pharmacokinetic reference models applicable to diverse populations ( 42 ). Future research should emphasize integrative, multicenter studies and open-access data sharing to foster inclusivity and translational relevance in this evolving field. A major thematic gap exists in the depth and breadth of comprehensive pharmacokinetic data for certain drug classes and mechanisms. While core themes focus on HIV and epilepsy, there is a clear and emerging need for more robust data on the other medications. Crucially, the thematic evolution points to a knowledge deficit in the underlying mechanisms of drug disposition, as an emerging cluster identified via Keyword Plus highlights a necessary shift toward detailed studies of "drug elimination," "metabolism," and "drug absorption" in pregnancy, which are essential for true dose optimization. The integrated thematic mapping and evolution analyses provide a nuanced view of the research landscape in pharmacokinetics during pregnancy. Across all three visualizations, pregnancy consistently emerged as the central theme, reflecting its role as the conceptual anchor of the field. Its persistence over time-from the early methodological studies of the 1970s to its consolidation as a dominant focus in recent decades-demonstrates recognition of pregnancy as a critical determinant of pharmacokinetic variability and therapeutic outcomes. However, the relatively low density of this cluster suggests that, while central, the theme remains in a developmental stage and has not yet matured into a fully cohesive area of research. The first thematic map positioned HIV, epilepsy, therapeutic drug monitoring, and lactation alongside pregnancy as basic and transversal themes, indicating their broad significance and their alignment with clinical challenges in maternal health. These findings are consistent with evidence that pregnancy alters the pharmacokinetics of antiretroviral therapy, often necessitating dose adjustments to maintain efficacy while minimizing toxicity ( 43 ). Gilbert et al. showed that absorption, distribution, metabolism, and excretion of antiretrovirals are substantially modified during pregnancy, requiring tailored therapeutic approaches. Similarly, Salama et al. highlighted the difficulties associated with pharmacokinetic boosters such as ritonavir and cobicistat, which display reduced activity in pregnant women ( 44 ).These examples illustrate why HIV-related topics cluster closely with pregnancy in the thematic maps. By contrast, themes such as cancer, chemotherapy, and children appeared as niche areas, well developed internally but weakly connected to the core, reflecting a fragmented contribution to the broader field. Emerging or declining topics such as progesterone, rat, and malaria suggest areas that are either losing prominence or remain underexplored, and notably, the absence of motor themes underscores a lack of fully integrated drivers of research. The second thematic map reinforced these patterns, with pregnancy and female again central but underdeveloped, while human/humans/article clustered as a niche theme, reflecting a concentration of descriptive or epidemiologic contributions with limited conceptual advancement. Meanwhile, pharmacokinetics, nonhuman, and animal were positioned as declining themes, indicating a shift away from preclinical models toward human-centered approaches. The consistency across both maps highlights enduring fragmentation in the field, where broad foundational topics remain important but lack the maturity and cohesion typical of motor themes. The thematic evolution analysis provided historical context for these patterns. In the earliest period (1971–1988), research was dominated by methodological descriptors such as human, nonhuman, kinetics, and pharmacokinetics, reflecting the foundational emphasis on experimental models. From 1989 to 2015, the field transitioned toward clinical relevance, with pregnancy becoming a dominant theme alongside disease-specific concerns such as epilepsy and HIV infection. These shifts reflect the growing recognition of the need to optimize therapeutic strategies in pregnant women with chronic conditions. More recently (2016–2025), pregnancy retained its centrality but was joined by the emergence of metabolism as a theme, indicating an increased focus on mechanistic aspects of drug disposition and the role of maternal physiology. This shift is consistent with recent reports emphasizing the importance of pregnancy-induced changes in enzymatic pathways and transporter systems that can significantly alter drug exposure ( 45 ),( 46 ). Collectively, these findings highlight both progress and gaps. The sustained centrality of pregnancy underscores its importance, while the emergence of metabolism signals a promising trend toward mechanistic integration. However, the absence of motor themes indicates that the field has not yet consolidated into mature, cohesive lines of inquiry. As others have noted, pharmacokinetic adaptations in pregnancy remain incompletely understood, with a need for integrative frameworks that connect disease-specific pharmacology, physiologic adaptation, and therapeutic optimization ( 45 ) ,( 47 ). Future research should therefore prioritize building cross-cutting models, such as physiologically based pharmacokinetic (PBPK) simulations, and integrating real-world pharmacokinetic monitoring with mechanistic insights to generate stronger thematic density and establish motor themes that can advance clinical and translational impact. The strengths of this study are that, to the best of our knowledge, it is the only qualitative and thematic analysis of the most comprehensive literature on pharmacokinetic changes during pregnancy and highlights the extent to which scientific research and scholars have contributed over the past years. Beyond the descriptive mapping of global research productivity, this study offers new interpretive insights into the scientific structure of pharmacokinetic research in pregnancy. The absence of motor themes and the predominance of low-density clusters suggest that the field remains conceptually fragmented and lacks a unified translational framework. The co-occurrence of emerging terms such as “metabolism,” “PBPK,” and “controlled study” indicates that mechanistic and model-informed approaches are beginning to bridge this gap. Importantly, our findings reveal that despite an expanding evidence base, pharmacokinetic research in pregnancy remains concentrated in specific therapeutic areas-chiefly antiretrovirals and antiepileptics-while other high-priority domains such as psychotropics, cardiovascular drugs, and biologics are underrepresented. These bibliometric patterns provide novel evidence that research prioritization remains skewed toward historically studied drug classes rather than population health needs, highlighting opportunities for realignment of research funding and regulatory focus. This study had several limitations. This study has several limitations that should be acknowledged. First, only the Scopus database was used to identify relevant publications. While Scopus is a comprehensive and widely recognized bibliometric resource, relying solely on a single database may have resulted in the exclusion of relevant studies indexed in other databases such as Web of Science, PubMed, Medline, or Google Scholar. This limitation may have affected the comprehensiveness of our findings and could potentially influence the observed trends in pharmacokinetic changes during pregnancy research. Furthermore, we encourage other scholars to merge the information and data derived from other sources to conduct the most comprehensive bibliometric analysis in this field. Second, this study included only English-language publications. Excluding non-English studies may have introduced a selection bias, potentially omitting relevant research published in other languages, which could underrepresent certain research contributions. Future studies could address these limitations by performing a comparative bibliometric analysis across multiple databases (e.g., Scopus, Web of Science, PubMed, Google Scholar) and including publications in multiple languages. Such an approach would provide a more holistic and representative view of research trends in pharmacokinetic changes during pregnancy. Conclusion and Future Research Directions Our findings provide the first qualitative overview of global research on pharmacokinetic changes during pregnancy, encompassing publications from 1971 to 2025. The analysis reveals a consistent rise in research output, reflecting growing recognition of pregnancy as a distinct pharmacological state that necessitates tailored therapeutic approaches. The United States, Italy, and New Zealand emerged as leading contributors, while the moderate level of international collaboration (18.89% co-authorship across 84 countries) highlights the potential for strengthening global partnerships. Key institutions, including the University of Washington and Wolters Kluwer Health-Adis, have been central to advancing scholarship in this domain. Thematic mapping identified “pregnancy” as the predominant focus, with recurrent topics such as HIV, epilepsy, therapeutic drug monitoring, and PBPK modeling, while emerging themes like metabolism and controlled studies point toward a transition from descriptive to mechanistic, model-informed research. Despite these developments, the absence of motor themes underscores fragmentation within the field and reveals persistent gaps in comprehensive pharmacokinetic data across drug classes and mechanistic pathways. Future research should advance beyond descriptive analyses toward integrative, mechanistic, and translational frameworks. Emphasis should be placed on the application of physiologically based and population pharmacokinetic modeling, coupled with real-world therapeutic monitoring, to capture pregnancy-specific physiological variability across trimesters. Expanding investigations beyond traditionally studied drugs-such as antiretrovirals and antiepileptics-to include psychotropic agents, cardiovascular therapies, immunomodulators, and biologics will help achieve a more inclusive evidence base. Strengthening global collaboration and ensuring representation from low- and middle-income countries will enhance the generalizability of findings and account for diverse genetic, dietary, and environmental influences. Parallel efforts should focus on harmonizing research protocols and ethical standards in partnership with regulatory authorities, thereby accelerating translation of pharmacokinetic data into clinical practice. Finally, embedding pregnancy pharmacokinetics within clinical pharmacology education and capacity-building initiatives will help bridge the gap between research and bedside application. Collectively, these strategies aim to transform pregnancy pharmacokinetic research into a cohesive, mechanistic, and clinically actionable discipline that informs safer and more individualized pharmacotherapy for pregnant populations worldwide. Study Highlights Pregnancy induces substantial alterations in pharmacokinetic parameters, yet global research on this topic remains fragmented across therapeutic areas and drug classes. This study provides the first comprehensive bibliometric and thematic overview of pharmacokinetic research in pregnancy, mapping global publication trends, collaborative networks, and emerging scientific directions. Analysis of 1,391 publications from 84 countries revealed steady annual growth (6.18%) and moderate international collaboration (18.89%), reflecting increasing but still uneven global engagement. The United States, Italy, and New Zealand were the leading contributors, while Clinical Pharmacokinetics and the University of Washington were identified as central publication and institutional hubs. Thematic analysis highlighted a shift from descriptive studies toward mechanistic, model-informed, and translational research, emphasizing the need for stronger integration, broader representation, and enhanced clinical applicability. Declarations Availability of supporting data The data supporting the findings of this study are available on the websites mentioned in the References section. Funding The authors did not receive support from any organization for the submitted work. Declaration of competing interests The authors have no relevant financial or nonfinancial interests to disclose. Ethical Approval Not applicable Credit authorship contribution statement Mohammed Jalal: Conceptualization, Methodology , Riad Mohammed Abdelrahman: Conceptualization, Methodology , Taha Hussein Musa: Conceptualization, Data Curation , Ismail Adam Arbab: Formal analysis, Writing – original draft , Eltieb Omer Ahmed: Conceptualization, Writing – review & editing , Sahar Ibrahim Gasmallah: Formal analysis, Writing – original draft , Wafaa Ramadan Ahmed: Conceptualization, Data Curation, Khalid Hamid Fadul: Conceptualization, Writing – review & editing Declaration of generative AI and AI-assisted technologies in the writing process ChatGPT and Grammarly were used solely to enhance the readability and language of the Introduction and Discussion sections. No AI tools were involved in data analysis, result interpretation, or content generation. All AI-assisted text was carefully reviewed and verified by the authors, who take full responsibility for the final manuscript. 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07:20:46","extension":"html","order_by":30,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":175577,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7965704/v1/1edef709beaa29f921d53f57.html"},{"id":94640879,"identity":"6f0d1301-20d2-48c0-9ca8-bf81308cf25c","added_by":"auto","created_at":"2025-10-29 07:50:19","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":375712,"visible":true,"origin":"","legend":"\u003cp\u003eSee image above for figure legend\u003c/p\u003e","description":"","filename":"1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-7965704/v1/5320006c06994c115524c81b.jpg"},{"id":94636956,"identity":"bec0c781-6c7e-4abd-b995-e9931c93a404","added_by":"auto","created_at":"2025-10-29 07:20:45","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":106076,"visible":true,"origin":"","legend":"\u003cp\u003eGeneral information and the trend of publication\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-7965704/v1/9ea2bb08eaa5ce26fd12f365.png"},{"id":94636963,"identity":"5e9948ca-dba1-43e8-b986-ebc5ac274e94","added_by":"auto","created_at":"2025-10-29 07:20:45","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":292379,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eAnnual growth of globally cited articles by year on in Pharmacokinetic Changes During Pregnancy indexed in Scopus. (A) Annual trend of the global production by year on in Pharmacokinetic Changes During Pregnancy described by an average mean of total citations per article and total citations per year for articles indexed in Scopus. (B)\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-7965704/v1/4275ab2988e5d0ba8e82cfd4.png"},{"id":94636959,"identity":"b491e758-647e-422f-8b65-601088773c5f","added_by":"auto","created_at":"2025-10-29 07:20:45","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":1723298,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eVisualization of keywords (A), keyword plus (B)\u003c/strong\u003e, \u003cstrong\u003eand\u003c/strong\u003e \u003cstrong\u003eoverlay visualization of the\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"4.png","url":"https://assets-eu.researchsquare.com/files/rs-7965704/v1/1e303cbc1a33c4b2de1e2472.png"},{"id":94636961,"identity":"bbc69fc6-b0b3-409e-9a23-306c629f9e80","added_by":"auto","created_at":"2025-10-29 07:20:45","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":257189,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eword cloud of publications on pharmacokinetic changes during pregnancy (1971–2025).\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"5.png","url":"https://assets-eu.researchsquare.com/files/rs-7965704/v1/a36a1a8ecabdb5a09fff1393.png"},{"id":94640706,"identity":"dc3ab119-feb1-4ac4-a676-b468df067ce6","added_by":"auto","created_at":"2025-10-29 07:50:07","extension":"png","order_by":6,"title":"Figure 6","display":"","copyAsset":false,"role":"figure","size":172194,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eThematic Map of Authors’Keywords (A) and Keywords Plus (B)\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"6.png","url":"https://assets-eu.researchsquare.com/files/rs-7965704/v1/f058376fc439934701ac3664.png"},{"id":94636964,"identity":"e8b6ba3a-178d-4bdf-b116-12bf32a40345","added_by":"auto","created_at":"2025-10-29 07:20:45","extension":"png","order_by":7,"title":"Figure 7","display":"","copyAsset":false,"role":"figure","size":204573,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eThematic evolution\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"7.png","url":"https://assets-eu.researchsquare.com/files/rs-7965704/v1/4301eeee7f0d507862fa304d.png"},{"id":94641148,"identity":"075325a6-62e4-4fbd-aff9-db60fb40722f","added_by":"auto","created_at":"2025-10-29 07:51:30","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":4313538,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7965704/v1/21377d1c-01cf-47f9-b6a7-9669708c7868.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003e\u003cstrong\u003eGlobal Trends in Pharmacokinetic Changes During Pregnancy: A Bibliometric and Thematic Analysis of Articles Indexed in Scopus (1971-2025)\u003c/strong\u003e\u003c/p\u003e","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003ePhysiological changes during pregnancy can significantly alter how drugs are absorbed, distributed, metabolized, and excreted, affecting their pharmacokinetics and pharmacodynamics. These changes may lead to either reduced or increased drug levels, potentially compromising treatment effectiveness or increasing the risk of adverse effects for both mother and fetus. (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e)\u003c/p\u003e\u003cp\u003eDespite this, optimal dosing in pregnancy is rarely studied, and pharmacokinetic changes for most medications remain poorly understood, making it unclear whether single or multiple dose adjustments are needed as pregnancy progresses.(\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e)\u003c/p\u003e\u003cp\u003ePregnancy induces significant anatomical and physiological changes across multiple organ systems, which can impact drug pharmacokinetics. These include reduced gastrointestinal motility and higher gastric pH (affecting drug absorption), increased body water and plasma volume, and lower drug-binding protein levels (altering drug distribution and sometimes clearance) (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eAdditionally, enhanced kidney function increases renal clearance, while liver enzyme activity changes affect drug metabolism. These physiological adjustments progress throughout pregnancy and generally peak in the third trimester, particularly changes in cardiac output, body water, fat stores, glomerular filtration rate, and plasma albumin levels (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eDespite its clinical importance, research on pharmacokinetics in pregnant women remains limited. Pregnant populations are often excluded from randomized controlled trials due to ethical and safety concerns, leaving clinicians to rely on small observational studies, extrapolations from nonpregnant adults, or post-marketing surveillance (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e),(\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). Consequently, the available knowledge is fragmented, discipline-specific, and often underpowered to guide evidence-based prescribing in pregnancy. The scarcity of comprehensive data contributes to the ongoing problem of medication underuse, misuse, and avoidable adverse maternal-fetal outcomes. Pharmacokinetic clinical trials exist for certain drug classes during pregnancy. A review found that since 2008, roughly one-third of these studies focused on drugs for labor and delivery, another third on treatments for infectious diseases, and the rest on various antepartum conditions (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e),(\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eOver 90% of pregnant individuals use at least one medication during pregnancy (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). However, for most medications used during pregnancy, data on pharmacokinetic changes and dosing requirements remain scarce. Furthermore, it is often unclear whether these pharmacokinetic changes affect drug efficacy or safety (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e),(\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThe physiological adaptations required to support fetal development-such as increased blood volume, enhanced renal clearance, and altered hepatic enzyme activity-significantly affect drug absorption, distribution, metabolism, and excretion (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e),(\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eStudying pharmacokinetics during pregnancy involves complex ethical challenges due to the need to protect both the mother and fetus while addressing a critical gap in medical knowledge (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). Key concerns include obtaining truly informed consent, minimizing fetal risk, and overcoming the historical exclusion of pregnant women from clinical trials, which limits safe treatment options. As a vulnerable population, pregnant individuals require additional protections to prevent exploitation (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eEthical research must also consider potential long-term effects on the child, ensure diverse representation to improve generalizability, and comply with rigorous regulatory and ethical standards. Balancing the potential benefits of research with the risks involved remains a central moral dilemma (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThe thalidomide tragedy (1957\u0026ndash;1961) significantly influenced ethical regulations and delayed direct studies in pregnant women for years. Thus, most pharmacokinetic insights prior to the 1960s were anecdotal or observational. Post-1960s, structured pharmacokinetic research began evolving, especially for drugs essential during pregnancy such as anticonvulsants, antimicrobials, and antiretrovirals (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e).\u003c/p\u003e\u003cp\u003ePharmacokinetic research in pregnancy has grown substantially, initially focusing on essential drugs like antiepileptics, antibiotics, and antiretrovirals, then expanding to cardiovascular drugs, antidepressants, immunosuppressants, and biologics (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eStudies have progressed from small observational designs to larger controlled and multicenter trials, incorporating advanced modeling approaches like population pharmacokinetics and physiologically based pharmacokinetic (PBPK) modeling (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eRecent research increasingly evaluates not only maternal pharmacokinetics but also placental drug transfer and fetal drug exposure to better understand safety profiles (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eOne of the earliest substantial pharmacokinetic studies in pregnant women was a prospective investigation by Lander et al. (1977), which examined plasma levels of antiepileptic drugs, including phenytoin, throughout pregnancy. They observed a significant reduction in circulating drug levels despite constant dosing, indicating increased drug clearance during pregnancy. Their findings reinforced the need for therapeutic drug monitoring and dosage adjustments in pregnant patients to maintain efficacy and safety (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eLiterature on pharmacokinetics during pregnancy is dispersed across multiple disciplines, including clinical pharmacology, obstetrics, pediatrics, maternal\u0026ndash;fetal medicine, and toxicology. Most existing studies are quantitative in nature, whereas qualitative investigations remain scarce. Consequently, no comprehensive overview currently exists to map influential research trends, thematic directions, or knowledge gaps in this field.\u003c/p\u003e\u003cp\u003eIn recent years, bibliometrics has gained significant attention as a method for swiftly analyzing scientific outputs both quantitatively and qualitatively. It serves as a crucial tool for evaluating the volume and impact of publications, such as journal articles and books (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eVisual analysis of the knowledge structure and emerging research hotspots within a specific field has proven effective in highlighting research progress and technological advancements. It also offers a theoretical basis and guidance for future investigations in the area (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eWhile bibliometric analysis has its limitations-such as the inability to assess research quality and its dependence on data source selection-it remains a valuable tool for identifying research trends and guiding future studies. However, it should be used alongside other methods like content analysis for a more comprehensive evaluation (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThis study aimed to perform a bibliometric and thematic analysis of the global articles on pharmacokinetic changes during pregnancy, indexed in the Scopus database from 1971 to 2025. By choosing this duration, we aimed to show the historical evolution of research.\u003c/p\u003e\u003cp\u003eThe longer period increases heterogeneity in study design and methodology, which may affect thematic analysis but is valuable for a comprehensive global overview.\u003c/p\u003e\u003cp\u003eHowever, for bibliometrics, older studies tend to have more citations, so we used citation/year normalization to avoid skewing results toward the oldest studies.\u003c/p\u003e\u003cp\u003eSpecifically, this work sought to map publication and citation patterns, identify key authors, journals, institutions, and countries contributing to this field, categorize major thematic areas addressed in highly cited literature; and highlight persistent knowledge gaps to inform future research and clinical practice.\u003c/p\u003e"},{"header":"2. Materials and Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003e2.1. Sources of data\u003c/h2\u003e\u003cp\u003eThis study aimed to conduct a Bibliometric and Thematic Analysis of the globally cited publications in Pharmacokinetic Changes During Pregnancy.\u003c/p\u003e\u003cp\u003eMetadata extracted for exploring the articles in Pharmacokinetic Changes During Pregnancy from 1971 to 2025 via the Scopus database (\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.scopus.com/\u003c/span\u003e\u003cspan address=\"https://www.scopus.com/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThe Scopus database is a platform that provides a unique advanced search world’s most trusted citation index for scientific and scholarly research and is used to provide researchers with a comprehensive dataset used subsequently for bibliometric analysis across many disciplines.\u003c/p\u003e\u003cp\u003eOn October 8th, 2025, we searched the Scopus database for articles on Pharmacokinetic Changes During Pregnancy published in peer-reviewed journals. A flowchart of the article screening process is shown in Fig.\u0026nbsp;1.\u003c/p\u003e\u003cp\u003eA Boolean search process includes the following subject term search formula: TITLE-ABS-KEY in Scopus databases related to spatial Pharmacokinetic Changes During Pregnancy: ((TITLE-ABS-KEY(Pharmacokinetics) AND TITLE-ABS-KEY(Pregnancy OR Pregnant) AND TITLE-ABS-KEY(Changes)) AND PUBYEAR \u0026gt; 1970 AND PUBYEAR \u0026lt; 2026 AND ( LIMIT-TO ( EXACTKEYWORD,\"Pregnancy\" ) OR LIMIT-TO ( EXACTKEYWORD,\"Pharmacokinetics\" ) OR LIMIT-TO ( EXACTKEYWORD,\"Drug Metabolism\" ) OR LIMIT-TO ( EXACTKEYWORD,\"Pregnant Woman\" ) OR LIMIT-TO ( EXACTKEYWORD,\"Drug Clearance\" ) OR LIMIT-TO ( EXACTKEYWORD,\"Drug Distribution\" ) OR LIMIT-TO ( EXACTKEYWORD,\"Drug Absorption\" ) OR LIMIT-TO ( EXACTKEYWORD,\"Drug Elimination\" ) OR LIMIT-TO ( EXACTKEYWORD,\"Pharmacokinetic Parameters\" ) OR LIMIT-TO ( EXACTKEYWORD,\"Drug Disposition\" ) OR LIMIT-TO ( EXACTKEYWORD,\"Drug Bioavailability\" ) OR LIMIT-TO ( EXACTKEYWORD,\"Drug Excretion\" ) ) AND ( LIMIT-TO ( DOCTYPE,\"ar\" ) OR LIMIT-TO ( DOCTYPE,\"re\" ) ) AND ( LIMIT-TO ( LANGUAGE,\"English\" ) ) ).\u003c/p\u003e\u003cp\u003eThe metadata on global Pharmacokinetic Changes During Pregnancy were extracted by the authors on October 8th, 2025, to avoid daily updating bias because the database is still open and the average number of citations can increase per day. The authors defined databases on the basis of their availability and data accessibility.\u003c/p\u003e\u003cp\u003eThe search records of global documents associated with Pharmacokinetic Changes During Pregnancy -indexed Scopus included 1391 documents after filtering by document type (review OR article) and language (English). The search was performed and the Scopus database was collected and exported in RIS, BibTeX, and CSV formats.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e\u003ch2\u003e2.2. Inclusion and Exclusion Criteria\u003c/h2\u003e\u003cp\u003eAn overall document of Pharmacokinetic Changes During Pregnancy -associated publications from the Scopus database was included in our analysis. The terms related with the Pharmacokinetic process were added as extra keywords. The exclusion criteria included all types of reported documents, such as (letters, notes, conference papers, short surveys, editorials, book chapters, errata, early access, proceedings papers, and undefined) publications, which were excluded from Scopus). Moreover, other non-English records were excluded.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e\u003ch2\u003e2.3. Bibliometric Analysis\u003c/h2\u003e\u003cp\u003eDescriptive statistical analyses of the key metadata, time series of publications, sources of local impact, author impact analysis, leading institutions, leading countries, and publication performance were performed via the Bibliometrix tool in R for Windows. VOS viewer (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e),(\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e) software was used for visual analysis of co-authorship networks, co-occurrence of reported keywords, and citation and co-citation maps based on bibliographic data. Thematic map visualization and evaluation were conducted via Bibliometrix to carry out conceptual network analysis, factorial analysis, social network analysis, and collaboration network analysis, whereas country collaboration maps were analyzed via R Studio version 4.4.3 software, Bibliometrix, the R package, and an online analysis platform. GraphPad Prism 9 (version 9.2.0, GraphPad Software LLC, United States) and OriginPro 2019 v9.6 were used for inferential statistical analysis and to correlate study variables. A P value less than or equal to 0.05 was considered statistically significant. Additionally, autocorrelation analysis and citation/year normalization (citation windows) were applied to the time-series data to assess temporal dependencies and patterns in publication trends.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\u003cp\u003e\u003c/p\u003e\u003c/div\u003e"},{"header":"3. Results","content":"\u003ch2\u003e3.1. Trends in global publication and main characteristics\u003c/h2\u003e\n\u003cp\u003eFigure \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e shows the descriptive summary statistical analysis of the 1391 identified global publications on Pharmacokinetic Changes During Pregnancy, including year, sources, annual growth, document contents, authors, and document types during the period of 1971\u0026ndash;2025. The included articles and reviews published in 511 sources by 8192 authors, with only one single-author documents and 16.89% international co-authorships. The annual growth rate was 6.18%.\u003c/p\u003e\n\u003ch2\u003e3.2. Performance analysis of in Pharmacokinetic Changes During Pregnancy -associated publications\u003c/h2\u003e\n\u003cp\u003eAs illustrated in Fig.\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e, the evolution of Pharmacokinetic Changes During Pregnancy-related publications between 1971 and 2025 shows an initial steady rise in scientific output up to 1986, followed by a consistent decline extending to 1999 to rise steadily again to reach a peak in 2024 (60 articles), start drop in 2025 (until October). Citation performance rise steadily from 1971, with the mean total citations per article (MeanTCperArt) reaching a peak of 8 in 2005, then fluctuate before reach a bottom in 2025. These results indicate that years with greater publication counts did not necessarily correspond to higher citation rates per year, though after 2000, periods of higher output were modestly associated with improved citation averages per article. Correlation analyses demonstrated significant positive relationships among most bibliometric indicators. The number of articles showed a moderate positive correlation with mean total citations per article (r\u0026thinsp;=\u0026thinsp;0.24, 95% CI [0.06\u0026ndash;0.40], p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and mean total citations per year (r\u0026thinsp;=\u0026thinsp;0.17, 95% CI [0.00\u0026ndash;0.33], p\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e\n\u003ch2\u003e3.3. Authorship analysis\u003c/h2\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Tab1\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eTop 10 authors' local impact on Pharmacokinetic Changes During Pregnancy -associated publications from the Scopus database (1971\u0026ndash;2025) on the basis of the h_index\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\u003ccolgroup\u003e\u003c/colgroup\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eAuthor (n\u0026thinsp;=\u0026thinsp;8,192)\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eh_index\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eg_index\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003em_index\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eTNC\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eTNP\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003ePY_start\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eDam, M.\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e50\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e50\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e13116\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e50\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1976\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eVoutilainen, R.\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e36\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e36\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.923\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e9189\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e36\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1987\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eCrema, A.\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e35\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e35\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.795\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e9365\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e35\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1982\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePeriyasamy, S.\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e28\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e28\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.651\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e6813\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e28\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1983\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eKellerman, D.\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e24\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e24\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.558\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e6051\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e24\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1983\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eLevy, G.\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e21\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e21\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.457\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e5788\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e21\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1980\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eChristiansen, J.\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e21\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e21\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.447\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e5256\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e21\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1979\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eLindberg, B.\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e18\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e18\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.439\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e4915\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e18\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1985\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eMcCormick, K.\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e16\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e16\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.444\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3572\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e16\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1990\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eBenfield, P.\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e16\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e16\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e0.4\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e4616\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e16\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1986\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eDam, M.\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e50\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e50\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e13116\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e50\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1976\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cem\u003eTNC, total number of citations; TNP, total number of publications; PY_start, publication year start.\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eA total of 8,192 authors contributed to global research on Pharmacokinetic Changes During Pregnancy. Among the most influential contributors, Dam, M. achieved the highest h-index (50), followed by Voutilainen, R. (h-index\u0026thinsp;=\u0026thinsp;36), as well as Crema, A. (h-index\u0026thinsp;=\u0026thinsp;35) (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e). Collaboration measures showed consistent positive associations with impact indicators. Weak but significant correlations were observed between the number of coauthors and total citations (r\u0026thinsp;=\u0026thinsp;0.16, 95% CI [0.00\u0026ndash;0.31], p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), h-index (r\u0026thinsp;=\u0026thinsp;0.16, 95% CI [0.00\u0026ndash;0.31], p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and g-index (r\u0026thinsp;=\u0026thinsp;0.16, 95% CI [0.00\u0026ndash;0.31], p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e shows top 10 most cited documents on Pharmacokinetic Changes During Pregnancy -associated publications from the Scopus database\u0026nbsp;\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Tab2\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eTop 10 most cited documents on Pharmacokinetic Changes During Pregnancy -associated publications from the Scopus database (1971\u0026ndash;2025)\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\u003ccolgroup\u003e\u003c/colgroup\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003ePaper\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eDOI\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eTotal Citations\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eTNC per Year\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eGrotenhermen, 2003, clin. pharmacokinet.\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.2165/00003088-200342040-00003\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1193\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e51.87\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePatsalos, 2008, Epilepsia\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1111/j.1528-1167.2008\u003c/span\u003e\u003c/span\u003e. 01561.x\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1018\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e56.56\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eSoldin, 2009, clin. pharmacokinet.\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.2165/00003088-200948030-00001\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e883\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e51.94\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eAnderson, 2005, clin. pharmacokinet.\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.2165/00003088-200544100-00001\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e597\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e28.43\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eCerbin-koczorowska, 2021, appl. sci.\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3390/app11114905\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e570\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e114.00\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eRosenberg, 2004, reg. anesth. pain med.\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.rapm.2004.08.003\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e498\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e22.64\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eShafer, 2005, environ. health perspect.\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1289/ehp.7254\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e467\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e22.24\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eDavies, 2000, clin. pharmacokinet.\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.2165/00003088-200038030-00003\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e414\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e15.92\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eChaffman, 1985, drugs\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.2165/00003495-198529050-00001\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e395\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e9.63\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eDunn, 1995, drugs\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.2165/00003495-199549050-00007\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e388\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e12.52\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003ch2\u003e3.4.\u0026nbsp;Corresponding Author\u0026rsquo;s countries\u003c/h2\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eAn analysis of global Pharmacokinetic Changes During Pregnancy publications revealed contributions from 84 countries, resulting in 18.89% international co-authorships (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e and Fig.\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e). Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e details the top ten countries contributing to Pharmacokinetic Changes During Pregnancy research productivity. The USA emerged as the most prolific contributor, with 184 publications (13%). Italy followed 70 publications (5%). Additionally, New Zealand ranked among the leading contributors, with 50 publications (4%).\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003cdiv class=\"colspec\" align=\"char\"\u003e\u0026nbsp;\u003c/div\u003e\n\u003ctable id=\"Tab3\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003e\u003cstrong\u003eTop 10 Corresponding Author\u0026rsquo;s Countries with higher production\u003c/strong\u003e of \u003cstrong\u003edocuments on Pharmacokinetic Changes During Pregnancy from the Scopus database (1971\u0026ndash;2025)\u003c/strong\u003e\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\u003ccolgroup\u003e\u003c/colgroup\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eCountry(n\u0026thinsp;=\u0026thinsp;84)\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eTNP\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eUSA\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e184\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eItaly\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e70\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNew Zealand\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e50\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eGermany\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e45\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eSweden\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e36\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eUK\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e35\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eAustralia\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e29\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eDenmark\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e21\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNorway\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e14\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eSpain\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e14\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003ch2\u003e3.5. Top 10 journals published articles on Pharmacokinetic Changes During Pregnancy\u003c/h2\u003e\n\u003cp\u003eA total of 511 journals published the 1391 identified articles on Pharmacokinetic Changes During Pregnancy (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e). Clinical Pharmacokinetics ranked first, with 64 documents and 7334 total citations, followed by Drugs Journal (46 documents) and 5449 citations, and the American journal of obstetrics and gynecology (32 articles, 918 citations). Perfect correlations were found between the number of articles and both the h-index and g-index (r\u0026thinsp;=\u0026thinsp;1.00, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), reflecting mathematical dependence between these variables. A moderate positive association was found between the number of articles and m-index (r\u0026thinsp;=\u0026thinsp;0.44, 95% CI [0.27\u0026ndash;0.58], p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), while a strong correlation was observed between the number of articles and total citations (r\u0026thinsp;=\u0026thinsp;0.61, 95% CI [0.47\u0026ndash;0.72], p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Autocorrelation diagnostics (Durbin\u0026ndash;Watson\u0026thinsp;\u0026asymp;\u0026thinsp;1.8\u0026ndash;2.1) indicated no significant temporal dependence. When adjusted for citation windows, the 2-year metrics showed weaker correlations (r\u0026thinsp;\u0026asymp;\u0026thinsp;0.15\u0026ndash;0.25) compared with stronger and more stable 5-year windows (r\u0026thinsp;\u0026asymp;\u0026thinsp;0.35\u0026ndash;0.50), consistent with citation maturation effects.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003cdiv class=\"colspec\" align=\"char\"\u003e\u0026nbsp;\u003c/div\u003e\n\u003ctable id=\"Tab4\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eTop 10 journals on Pharmacokinetic Changes During Pregnancy -associated publications from the Scopus database by the number of local citations h_index (1971\u0026ndash;2025)\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\u003ccolgroup\u003e\u003c/colgroup\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eSource (n\u0026thinsp;=\u0026thinsp;511)\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eh_index\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eg_index\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003em_index\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eTNC\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eTNP\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003ePY_start\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eClinical pharmacokinetics\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e41\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e64\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.82\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e7334\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e64\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1976\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eDrugs\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e41\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e46\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.837\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e5449\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e46\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1977\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eAmerican journal of obstetrics and gynecology\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e19\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e30\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.365\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e918\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e32\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1974\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eClinical pharmacology and therapeutics\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e19\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e28\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.365\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1690\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e28\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1974\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eBritish journal of clinical pharmacology\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e16\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e27\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.32\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e887\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e27\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1976\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eEndocrinology (united states)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e16\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e25\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.302\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1032\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e25\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1973\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eDrug metabolism and disposition\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e14\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e29\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.275\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e900\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e32\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1975\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eJournal of clinical pharmacology\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e14\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e24\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.35\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e620\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e32\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1986\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eEpilepsia\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e13\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e17\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.317\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2134\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e17\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1985\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eEuropean journal of clinical pharmacology\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e13\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e17\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.245\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e617\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e17\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e1973\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u0026nbsp;\u003cem\u003eTNC, total number of citations; TNP, total number of publications; PY_start, publication year start.\u003c/em\u003e\u003c/p\u003e\n\u003ch2\u003e3.6. Analysis of the top 10 relevant affiliations or institution influence (1971\u0026ndash;2025)\u003c/h2\u003e\n\u003cp\u003eA total of 1487 institutions were reported. Many scientific institutions have provided evidence that research institutions have played a crucial role in driving research productivity on Pharmacokinetic Changes During Pregnancy -associated publications from the Scopus database over the past 24 years. With 14 as a minimum number of publications for the institution,22 met criteria. university of Washington, Seattle, United States, had a greater influence on these institutions, with 56 articles with 3065 citations and 33 total link strengths. However, Wolters Kluwer health - Adis, Auckland, New Zealand, has the highest number of citations (4085) for only 35 articles, with a zero total link strength. (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e5\u003c/span\u003e).\u0026nbsp;\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Tab5\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eAnalysis of the top 10 most institutional influences contributed by articles on Pharmacokinetic Changes During Pregnancy (1971\u0026ndash;2025)\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\u003ccolgroup\u003e\u003c/colgroup\u003e\n\u003cthead\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003cth style=\"height: 35px;\" align=\"left\"\u003e\n\u003cp\u003eNo\u003c/p\u003e\n\u003c/th\u003e\n\u003cth style=\"height: 35px;\" align=\"left\"\u003e\n\u003cp\u003eInstitution (n\u0026thinsp;=\u0026thinsp;1487)\u003c/p\u003e\n\u003c/th\u003e\n\u003cth style=\"height: 35px;\" align=\"left\"\u003e\n\u003cp\u003eDocuments\u003c/p\u003e\n\u003c/th\u003e\n\u003cth style=\"height: 35px;\" align=\"left\"\u003e\n\u003cp\u003eCitations\u003c/p\u003e\n\u003c/th\u003e\n\u003cth style=\"height: 35px;\" align=\"left\"\u003e\n\u003cp\u003eTLS\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\" align=\"left\"\u003e\n\u003cp\u003e1.\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"left\"\u003e\n\u003cp\u003e\"University of Washington, Seattle, united states\"\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e56\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e3065\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e33\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\" align=\"left\"\u003e\n\u003cp\u003e2.\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"left\"\u003e\n\u003cp\u003e\"Wolters Kluwer health - Adis, Auckland, New Zealand\"\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e35\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e4085\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e0\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\" align=\"left\"\u003e\n\u003cp\u003e3.\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"left\"\u003e\n\u003cp\u003e\"Food and drug administration, silver spring, united states\"\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e28\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e693\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e23\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\" align=\"left\"\u003e\n\u003cp\u003e4.\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"left\"\u003e\n\u003cp\u003e\"University of Pittsburgh school of medicine, Pittsburgh, united states\"\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e28\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e1003\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e37\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\" align=\"left\"\u003e\n\u003cp\u003e5.\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"left\"\u003e\n\u003cp\u003e\"University of Liverpool, Liverpool, United Kingdom\"\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e27\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e467\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e15\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\" align=\"left\"\u003e\n\u003cp\u003e6.\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"left\"\u003e\n\u003cp\u003e\"Certara, United Kingdom, canterbury, United Kingdom\"\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e26\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e1322\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e15\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\" align=\"left\"\u003e\n\u003cp\u003e7.\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"left\"\u003e\n\u003cp\u003e\"National institute of child health and human development (nichd), Bethesda, united states\"\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e22\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e1834\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e23\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\" align=\"left\"\u003e\n\u003cp\u003e8.\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"left\"\u003e\n\u003cp\u003e\"Northwestern university Feinberg school of medicine, Chicago, united states\"\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e22\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e564\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e12\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\" align=\"left\"\u003e\n\u003cp\u003e9.\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"left\"\u003e\n\u003cp\u003e\"Boston university Chobani an \u0026amp; Avedisian school of medicine, Boston, united states\"\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e20\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e540\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e26\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\" align=\"left\"\u003e\n\u003cp\u003e10.\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"left\"\u003e\n\u003cp\u003e\"University of Pittsburgh, Pittsburgh, united states\"\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e20\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e709\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e37\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003ctfoot\u003e\n\u003ctr style=\"height: 13.4609px;\"\u003e\n\u003ctd style=\"height: 13.4609px;\" colspan=\"5\"\u003e\u003cem\u003eTLS; Total length strength\u003c/em\u003e\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tfoot\u003e\n\u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u0026nbsp;3.7.\u0026nbsp;\u003cstrong\u003e\u003cem\u003eKeywords analysis\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAccording to the co-occurrence analysis shown in Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e6\u003c/span\u003e and Fig.\u0026nbsp;4 via VOS viewer, the total number of identified author keywords was 2103, and the number of keywords plus was 10778. When analyzed the author keyword with minimum occurrence of 8 ; 34 met the criteria ; \u0026ldquo;pregnancy\u0026rdquo; appears 374 times with a total link strength (TLS) of 515, followed by \u0026ldquo;pharmacokinetics\u0026rdquo; with 283 occurrences and 443TLS, then \u0026ldquo;HIV\" with 43 occurrences and 82 TLS, \u0026ldquo;epilepsy\u0026rdquo; occurs 40 times with 97 link strength, \u0026ldquo;pbpk\u0026rdquo; arriving approximately 38 times with 61 TLS, the keyword \u0026ldquo;therapeutic drug monitoring\u0026rdquo; occurs 27 times with 66 TLS (Fig.\u0026nbsp;4A).\u003c/p\u003e\n\u003cp\u003eIn the keyword plus analysis, with minimum occurrences of 170; 28 met the criteria, \u0026ldquo;pregnancy\u0026rdquo;, with 1267 occurrences have 9800 TLSs. The words indicate that \u0026ldquo;female\u0026rdquo; occurred in total in 1156, with 9349TLSs, and the words \u0026ldquo;human\u0026rdquo; occurred in 963, TLS 7299, in last the words \u0026ldquo;pharmacokinetics\u0026rdquo; occurred 885 with 6752TLS (Fig.\u0026nbsp;4B).\u003c/p\u003e\n\u003cp\u003eOverlay visualization of the co-occurrence analysis of Keywords Plus over the years in Fig.\u0026nbsp;4C shows that new and emerging topics starting in 2010 concern the words \u0026ldquo;human,\u0026rdquo; \u0026ldquo;metabolism,\u0026rdquo; and \u0026ldquo;controlled study\u0026rdquo;. Figure\u0026nbsp;5 shows the word cloud of publications on pharmacokinetic changes during pregnancy (1971\u0026ndash;2025).\u0026nbsp;\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Tab6\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eCo-occurrence of keywords through VOS viewer\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\u003ccolgroup\u003e\u003c/colgroup\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eType\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eOccurrences\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eTotal Link Strength\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003cth colspan=\"3\" align=\"left\"\u003e\n\u003cp\u003e\u003cem\u003eKeyword (n\u0026thinsp;=\u0026thinsp;2103)\u003c/em\u003e\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003epregnancy\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e374\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e515\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003epharmacokinetics\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e283\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e443\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ehiv\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e43\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e82\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eepilepsy\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e40\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e97\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003epbpk\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e38\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e61\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003etherapeutic drug monitoring\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e27\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e66\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003elactation\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e25\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e50\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003epharmacodynamics\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e24\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e52\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eplacenta\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e22\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e35\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003epostpartum\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e21\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e46\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd colspan=\"3\" align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003eKeyword plus(n\u0026thinsp;=\u0026thinsp;10778)\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003epregnancy\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1267\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e9800\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003efemale\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1156\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e9349\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ehuman\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e963\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e7299\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003epharmacokinetics\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e885\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e6752\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ehumans\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e641\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e5344\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003earticle\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e637\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e5528\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003epriority journal\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e520\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e4588\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eadult\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e416\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3538\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003enonhuman\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e395\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e3629\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ereview\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e370\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2717\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003ch2\u003e3.8. Thematic analysis\u003c/h2\u003e\n\u003cp\u003eAs shown in Fig.\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e6\u003c/span\u003eA, the thematic mapping of the author keywords revealed distinct clusters across the four themes. Within the basic theme, core topics such as pregnancy, pharmacokinetics, HIV, epilepsy, therapeutic drug monitoring, lactation, pregnant women, and special populations were identified. These themes demonstrate high centrality, highlighting their importance and relevance to the broader field. However, their relatively low density suggests that, while foundational, these topics remain conceptually underdeveloped and continue to evolve as central areas of investigation.\u003c/p\u003e\n\u003cp\u003eThe niche theme included cancer, chemotherapy, treatment, children, drugs, nicotine, and antibiotics. These themes were characterized by high density but low centrality, indicating that they are well-developed within themselves but relatively isolated from the central knowledge structure of the field. Such themes represent specialized areas of study that contribute important but peripheral insights.\u003c/p\u003e\n\u003cp\u003eIn the emerging theme, progesterone, rat, and malaria were identified. Their position indicates that these topics are either losing prominence or are in the early stages of development, with limited integration into the wider research framework. These themes may represent areas requiring renewed focus to determine their future trajectory within the field.\u003c/p\u003e\n\u003cp\u003eNotably, the motor theme, typically occupied by well-developed and highly relevant topics, was unpopulated. This absence suggests that no dominant, fully mature research theme currently drives the field, reflecting a lack of cohesive integration and signaling opportunities for further consolidation of knowledge.\u003c/p\u003e\n\u003cp\u003eFigure \u003cspan class=\"InternalRef\"\u003e6\u003c/span\u003eB illustrates the keyword plus thematic mapping. It revealed a concentration of themes across three quadrants. In the basic theme, the dominant concepts included pregnancy, female, and priority journal. Their high centrality underscores their importance to the structure of the field, serving as foundational areas of research. However, the low density of these clusters reflects their broad but underdeveloped nature, suggesting that while central to the discipline, further conceptual refinement is still needed.\u003c/p\u003e\n\u003cp\u003eWithin the niche theme, the cluster comprising human, humans, and article was identified. This theme demonstrated high density but low centrality, indicating it is internally well-developed yet somewhat isolated from the broader research network. Its strong cohesion points to a focused body of work, though with limited integration into the wider thematic structure.\u003c/p\u003e\n\u003cp\u003eThe emerging theme included pharmacokinetics, nonhuman, and animal. These themes exhibited both low density and centrality, implying that they are either losing relevance in the current research landscape or are underdeveloped areas that may warrant further exploration to establish their role in advancing the field.\u003c/p\u003e\n\u003cp\u003eNotably, the motor theme remained unpopulated, indicating the absence of mature, well-integrated, and driving themes that could provide direction for future research.\u0026nbsp;\u003c/p\u003e\n\u003ch2\u003e3.9. Thematic evolution\u003c/h2\u003e\n\u003cp\u003eThe thematic evolution analysis (Fig.\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e7\u003c/span\u003e) illustrates how research themes have shifted over time across three distinct periods (1971\u0026ndash;1988, 1989\u0026ndash;2015, and 2016\u0026ndash;2025). During the earliest period (1971\u0026ndash;1988), the focus was largely on broad methodological and experimental descriptors such as human, nonhuman, kinetics, and pharmacokinetics. These themes reflect the foundational stage of research, with emphasis on basic experimental models and pharmacokinetic principles.\u003c/p\u003e\n\u003cp\u003eIn the second phase (1989\u0026ndash;2015), there was a clear transition toward more clinically relevant themes. The emergence of pregnancy as a central concept marked a significant shift, integrating earlier pharmacokinetic investigations into maternal health contexts. Additionally, epilepsy and human immunodeficiency virus (HIV) infection gained prominence, reflecting growing concern over therapeutic drug use in special populations during pregnancy. The theme article also appeared, suggesting increasing publication output and formalization of the field.\u003c/p\u003e\n\u003cp\u003eIn the most recent period (2016\u0026ndash;2025), pregnancy has remained a dominant and persistent theme, demonstrating continuity and sustained centrality in the field. At the same time, new directions have emerged, particularly the appearance of metabolism, which indicates an increasing focus on mechanistic insights into drug disposition during pregnancy. This progression underscores a broadening of the research scope, moving from descriptive pharmacokinetics toward integrative approaches that link maternal physiology, therapeutic needs, and drug metabolism.\u003c/p\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eVarious quantitative systematic reviews and meta-analyses have examined pharmacokinetic changes during pregnancy (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e),(\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e). However, to the best of our knowledge, no qualitative or bibliometric analysis has been conducted to explore research trends, thematic evolution, or collaboration networks in this field. The present study represents the first bibliometric analysis to visualize the global research landscape, identify emerging topics, and highlight influential authors, institutions, and collaborative clusters related to pharmacokinetic changes during pregnancy. This study also helps lay the groundwork for new or emerging aspects of the topic of pharmacokinetic changes during pregnancy research areas.\u003c/p\u003e\u003cp\u003eThis bibliometric analysis provides a comprehensive overview of global research trends on pharmacokinetic changes during pregnancy from 1971 to 2025. The observed steady rise in publications over the decades reflects the increasing recognition of pregnancy as a special pharmacological state requiring distinct therapeutic considerations. The annual growth rate of 6.18% aligns with bibliometric trends reported in maternal-fetal pharmacology and drug safety literature, indicating expanding interdisciplinary interest and regulatory attention to individualized drug therapy in pregnant women (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e), (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThe correlation analyses revealed significant positive associations among key bibliometric indicators, suggesting that productivity and citation impact evolve in parallel across this research field. The moderate correlations between the number of articles and mean total citations per article (r = 0.24) or per year (r = 0.17) are consistent with earlier bibliometric findings in pharmacokinetic and clinical pharmacology domains, where publication volume modestly enhances visibility but not necessarily per-article impact (\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e), (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e). Similarly, weak yet significant associations between the number of authors and impact indicators such as total citations and h-index (r = 0.16) highlight the collaborative but specialized nature of research in this area. Prior analyses suggest that collaboration fosters dissemination and quality through methodological diversity and international expertise (\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e), (\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThe perfect correlations observed between the number of publications and both h- and g-indices (r = 1.00) are attributable to their structural dependence on publication count, consistent with earlier bibliometric validations (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e). Meanwhile, the moderate correlation with the m-index (r = 0.44) indicates that sustained scholarly engagement over time remains an important determinant of influence, as the m-index accounts for career duration and temporal consistency (\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e).The strong correlation between publication count and total citations (r = 0.61) reinforces that long-term productivity translates to cumulative academic influence.\u003c/p\u003e\u003cp\u003eAutocorrelation diagnostics (Durbin-Watson = 1.8–2.1) showed no significant non-independence, confirming statistical robustness and temporal stability in citation patterns. When citation windows were considered, weaker associations in 2-year windows compared to stronger and more stable 5-year correlations (r = 0.35–0.50) reflected the citation maturation phenomenon, as pharmacokinetic and clinical studies typically accumulate citations gradually due to extended validation and translational application timelines (\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e), (\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eInstitutional analysis revealed that the University of Washington and Wolters Kluwer Health–Adis emerged as dominant contributors in terms of both productivity and citation performance, consistent with their established leadership in pharmacokinetics, drug safety, and maternal health research. The keyword and thematic mapping highlighted “pregnancy,” “pharmacokinetics,” “PBPK modeling,” and “therapeutic drug monitoring” as recurring core terms, aligning with contemporary focus on model-informed precision dosing and physiologically based pharmacokinetic (PBPK) modeling (\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e), (\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e). Emerging topics such as “metabolism” and “controlled studies” suggest an ongoing shift toward translational pharmacology and real-world evidence generation in this population.\u003c/p\u003e\u003cp\u003eOverall, these findings confirm that the field of pharmacokinetics during pregnancy is evolving from descriptive pharmacology toward data-driven, mechanistic, and computational modeling approaches, with increasing international collaboration and expanding scientific impact. Continued integration of bibliometric and scientometric methods-such as time-series modeling, autocorrelation analysis, and citation window standardization-will be critical to monitor future developments and identify influential research streams.\u003c/p\u003e\u003cp\u003eThe global landscape of research on Pharmacokinetic Changes During Pregnancy demonstrates active scientific engagement across 84 countries, reflecting the growing international recognition of this topic’s clinical and pharmacological significance. The analysis revealed an international co-authorship rate of 18.89%, indicating a moderate yet meaningful level of global collaboration. Such cross-border cooperation is essential for advancing pharmacokinetic research in pregnancy, as it allows for pooling of diverse clinical data, harmonization of analytical methods, and broader applicability of findings across different populations (\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e),(\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThe United States emerged as the most prolific contributor, accounting for 184 publications (13%) of the total research output. This predominance aligns with the U.S. leadership in biomedical research infrastructure and its extensive clinical trial ecosystem focused on maternal and fetal health. Italy ranked second with 70 publications (5%), reflecting Europe’s sustained contribution to pharmacological sciences and its active involvement in maternal pharmacotherapy studies. Notably, New Zealand, despite its smaller research base, ranked among the top contributors with 50 publications (4%), highlighting its emerging influence in pregnancy pharmacokinetics and maternal health research (\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThe overall distribution of research output underscores a clear dominance of high-income countries in this domain, which is consistent with trends observed in other areas of clinical pharmacology. Limited participation from low- and middle-income countries (LMICs) may be attributed to restricted access to research funding, limited pharmacokinetic laboratory capacity, and underrepresentation in clinical studies involving pregnant populations (\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e). Strengthening collaborative research frameworks and capacity-building initiatives in LMICs could help bridge these disparities and promote a more globally representative understanding of pharmacokinetic changes during pregnancy.\u003c/p\u003e\u003cp\u003eThe observed 18.89% international co-authorship rate, while positive, suggests potential for further improvement in global scientific networking. Enhanced collaboration can lead to better data standardization, improve study reproducibility, and support the development of international pharmacokinetic reference models applicable to diverse populations (\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e). Future research should emphasize integrative, multicenter studies and open-access data sharing to foster inclusivity and translational relevance in this evolving field.\u003c/p\u003e\u003cp\u003eA major thematic gap exists in the depth and breadth of comprehensive pharmacokinetic data for certain drug classes and mechanisms. While core themes focus on HIV and epilepsy, there is a clear and emerging need for more robust data on the other medications. Crucially, the thematic evolution points to a knowledge deficit in the underlying mechanisms of drug disposition, as an emerging cluster identified via Keyword Plus highlights a necessary shift toward detailed studies of \"drug elimination,\" \"metabolism,\" and \"drug absorption\" in pregnancy, which are essential for true dose optimization.\u003c/p\u003e\u003cp\u003eThe integrated thematic mapping and evolution analyses provide a nuanced view of the research landscape in pharmacokinetics during pregnancy. Across all three visualizations, pregnancy consistently emerged as the central theme, reflecting its role as the conceptual anchor of the field. Its persistence over time-from the early methodological studies of the 1970s to its consolidation as a dominant focus in recent decades-demonstrates recognition of pregnancy as a critical determinant of pharmacokinetic variability and therapeutic outcomes. However, the relatively low density of this cluster suggests that, while central, the theme remains in a developmental stage and has not yet matured into a fully cohesive area of research.\u003c/p\u003e\u003cp\u003eThe first thematic map positioned HIV, epilepsy, therapeutic drug monitoring, and lactation alongside pregnancy as basic and transversal themes, indicating their broad significance and their alignment with clinical challenges in maternal health. These findings are consistent with evidence that pregnancy alters the pharmacokinetics of antiretroviral therapy, often necessitating dose adjustments to maintain efficacy while minimizing toxicity (\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e). Gilbert et al. showed that absorption, distribution, metabolism, and excretion of antiretrovirals are substantially modified during pregnancy, requiring tailored therapeutic approaches. Similarly, Salama et al. highlighted the difficulties associated with pharmacokinetic boosters such as ritonavir and cobicistat, which display reduced activity in pregnant women (\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e).These examples illustrate why HIV-related topics cluster closely with pregnancy in the thematic maps. By contrast, themes such as cancer, chemotherapy, and children appeared as niche areas, well developed internally but weakly connected to the core, reflecting a fragmented contribution to the broader field. Emerging or declining topics such as progesterone, rat, and malaria suggest areas that are either losing prominence or remain underexplored, and notably, the absence of motor themes underscores a lack of fully integrated drivers of research.\u003c/p\u003e\u003cp\u003eThe second thematic map reinforced these patterns, with pregnancy and female again central but underdeveloped, while human/humans/article clustered as a niche theme, reflecting a concentration of descriptive or epidemiologic contributions with limited conceptual advancement. Meanwhile, pharmacokinetics, nonhuman, and animal were positioned as declining themes, indicating a shift away from preclinical models toward human-centered approaches. The consistency across both maps highlights enduring fragmentation in the field, where broad foundational topics remain important but lack the maturity and cohesion typical of motor themes.\u003c/p\u003e\u003cp\u003eThe thematic evolution analysis provided historical context for these patterns. In the earliest period (1971–1988), research was dominated by methodological descriptors such as human, nonhuman, kinetics, and pharmacokinetics, reflecting the foundational emphasis on experimental models. From 1989 to 2015, the field transitioned toward clinical relevance, with pregnancy becoming a dominant theme alongside disease-specific concerns such as epilepsy and HIV infection. These shifts reflect the growing recognition of the need to optimize therapeutic strategies in pregnant women with chronic conditions. More recently (2016–2025), pregnancy retained its centrality but was joined by the emergence of metabolism as a theme, indicating an increased focus on mechanistic aspects of drug disposition and the role of maternal physiology. This shift is consistent with recent reports emphasizing the importance of pregnancy-induced changes in enzymatic pathways and transporter systems that can significantly alter drug exposure (\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e),(\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eCollectively, these findings highlight both progress and gaps. The sustained centrality of pregnancy underscores its importance, while the emergence of metabolism signals a promising trend toward mechanistic integration. However, the absence of motor themes indicates that the field has not yet consolidated into mature, cohesive lines of inquiry. As others have noted, pharmacokinetic adaptations in pregnancy remain incompletely understood, with a need for integrative frameworks that connect disease-specific pharmacology, physiologic adaptation, and therapeutic optimization (\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e) ,(\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e). Future research should therefore prioritize building cross-cutting models, such as physiologically based pharmacokinetic (PBPK) simulations, and integrating real-world pharmacokinetic monitoring with mechanistic insights to generate stronger thematic density and establish motor themes that can advance clinical and translational impact.\u003c/p\u003e\u003cp\u003eThe strengths of this study are that, to the best of our knowledge, it is the only qualitative and thematic analysis of the most comprehensive literature on pharmacokinetic changes during pregnancy and highlights the extent to which scientific research and scholars have contributed over the past years.\u003c/p\u003e\u003cp\u003eBeyond the descriptive mapping of global research productivity, this study offers new interpretive insights into the scientific structure of pharmacokinetic research in pregnancy. The absence of motor themes and the predominance of low-density clusters suggest that the field remains conceptually fragmented and lacks a unified translational framework. The co-occurrence of emerging terms such as “metabolism,” “PBPK,” and “controlled study” indicates that mechanistic and model-informed approaches are beginning to bridge this gap. Importantly, our findings reveal that despite an expanding evidence base, pharmacokinetic research in pregnancy remains concentrated in specific therapeutic areas-chiefly antiretrovirals and antiepileptics-while other high-priority domains such as psychotropics, cardiovascular drugs, and biologics are underrepresented. These bibliometric patterns provide novel evidence that research prioritization remains skewed toward historically studied drug classes rather than population health needs, highlighting opportunities for realignment of research funding and regulatory focus.\u003c/p\u003e\u003cp\u003eThis study had several limitations. This study has several limitations that should be acknowledged. First, only the Scopus database was used to identify relevant publications. While Scopus is a comprehensive and widely recognized bibliometric resource, relying solely on a single database may have resulted in the exclusion of relevant studies indexed in other databases such as Web of Science, PubMed, Medline, or Google Scholar. This limitation may have affected the comprehensiveness of our findings and could potentially influence the observed trends in pharmacokinetic changes during pregnancy research. Furthermore, we encourage other scholars to merge the information and data derived from other sources to conduct the most comprehensive bibliometric analysis in this field.\u003c/p\u003e\u003cp\u003eSecond, this study included only English-language publications. Excluding non-English studies may have introduced a selection bias, potentially omitting relevant research published in other languages, which could underrepresent certain research contributions. Future studies could address these limitations by performing a comparative bibliometric analysis across multiple databases (e.g., Scopus, Web of Science, PubMed, Google Scholar) and including publications in multiple languages. Such an approach would provide a more holistic and representative view of research trends in pharmacokinetic changes during pregnancy.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e"},{"header":"Conclusion and Future Research Directions","content":"\u003cp\u003eOur findings provide the first qualitative overview of global research on pharmacokinetic changes during pregnancy, encompassing publications from 1971 to 2025. The analysis reveals a consistent rise in research output, reflecting growing recognition of pregnancy as a distinct pharmacological state that necessitates tailored therapeutic approaches. The United States, Italy, and New Zealand emerged as leading contributors, while the moderate level of international collaboration (18.89% co-authorship across 84 countries) highlights the potential for strengthening global partnerships. Key institutions, including the University of Washington and Wolters Kluwer Health-Adis, have been central to advancing scholarship in this domain. Thematic mapping identified “pregnancy” as the predominant focus, with recurrent topics such as HIV, epilepsy, therapeutic drug monitoring, and PBPK modeling, while emerging themes like metabolism and controlled studies point toward a transition from descriptive to mechanistic, model-informed research. Despite these developments, the absence of motor themes underscores fragmentation within the field and reveals persistent gaps in comprehensive pharmacokinetic data across drug classes and mechanistic pathways.\u003c/p\u003e\u003cp\u003eFuture research should advance beyond descriptive analyses toward integrative, mechanistic, and translational frameworks. Emphasis should be placed on the application of physiologically based and population pharmacokinetic modeling, coupled with real-world therapeutic monitoring, to capture pregnancy-specific physiological variability across trimesters. Expanding investigations beyond traditionally studied drugs-such as antiretrovirals and antiepileptics-to include psychotropic agents, cardiovascular therapies, immunomodulators, and biologics will help achieve a more inclusive evidence base. Strengthening global collaboration and ensuring representation from low- and middle-income countries will enhance the generalizability of findings and account for diverse genetic, dietary, and environmental influences. Parallel efforts should focus on harmonizing research protocols and ethical standards in partnership with regulatory authorities, thereby accelerating translation of pharmacokinetic data into clinical practice.\u003c/p\u003e\u003cp\u003eFinally, embedding pregnancy pharmacokinetics within clinical pharmacology education and capacity-building initiatives will help bridge the gap between research and bedside application. Collectively, these strategies aim to transform pregnancy pharmacokinetic research into a cohesive, mechanistic, and clinically actionable discipline that informs safer and more individualized pharmacotherapy for pregnant populations worldwide.\u003c/p\u003e\u003cp\u003e\u003cb\u003eStudy Highlights\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003col\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003ePregnancy induces substantial alterations in pharmacokinetic parameters, yet global research on this topic remains fragmented across therapeutic areas and drug classes.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eThis study provides the first comprehensive bibliometric and thematic overview of pharmacokinetic research in pregnancy, mapping global publication trends, collaborative networks, and emerging scientific directions.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eAnalysis of 1,391 publications from 84 countries revealed steady annual growth (6.18%) and moderate international collaboration (18.89%), reflecting increasing but still uneven global engagement.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eThe United States, Italy, and New Zealand were the leading contributors, while Clinical Pharmacokinetics and the University of Washington were identified as central publication and institutional hubs.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eThematic analysis highlighted a shift from descriptive studies toward mechanistic, model-informed, and translational research, emphasizing the need for stronger integration, broader representation, and enhanced clinical applicability.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003c/ol\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAvailability of supporting data\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data supporting the findings of this study are available on the websites mentioned in the References section.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors did not receive support from any organization for the submitted work.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDeclaration of competing interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors have no relevant financial or nonfinancial interests to disclose.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical Approval\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCredit authorship contribution statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMohammed Jalal:\u003c/strong\u003e Conceptualization, Methodology\u003cstrong\u003e, Riad Mohammed Abdelrahman:\u0026nbsp;\u003c/strong\u003eConceptualization, Methodology\u003cstrong\u003e, Taha Hussein Musa:\u0026nbsp;\u003c/strong\u003eConceptualization, Data Curation\u003cstrong\u003e, Ismail Adam Arbab:\u0026nbsp;\u003c/strong\u003eFormal analysis, Writing – original draft\u003cstrong\u003e, Eltieb Omer Ahmed:\u0026nbsp;\u003c/strong\u003eConceptualization, Writing – review \u0026amp; editing\u003cstrong\u003e, Sahar Ibrahim Gasmallah:\u003c/strong\u003e Formal analysis, Writing – original draft\u003cstrong\u003e, Wafaa Ramadan Ahmed:\u0026nbsp;\u003c/strong\u003eConceptualization, Data Curation,\u003cstrong\u003e\u0026nbsp;Khalid Hamid Fadul:\u003c/strong\u003e Conceptualization, Writing – review \u0026amp; editing\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDeclaration of generative AI and AI-assisted technologies in the writing process\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eChatGPT and Grammarly were used solely to enhance the readability and language of the Introduction and Discussion sections. No AI tools were involved in data analysis, result interpretation, or content generation. All AI-assisted text was carefully reviewed and verified by the authors, who take full responsibility for the final manuscript.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eCoppola P, Kerwash E, Nooney J, Omran A, Cole S Pharmacokinetic data in pregnancy: A review of available literature data and important considerations in collecting clinical data. Front Med [Internet]. 2022 Oct 4 [cited 2025 Jul 27];9:940644. Available from: www.clinicaltrials.gov\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eCole S, Coppola P, Kerwash E, Nooney J, Lam SP Pharmacokinetic Characterization to Enable Medicine Use in Pregnancy, the Potential Role of Physiologically-Based Pharmacokinetic Modeling: A Regulatory Perspective. CPT Pharmacometrics Syst Pharmacol [Internet]. 2020 Oct 1 [cited 2025 Jul 27];9(10):547\u0026ndash;9. 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Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.mdpi.com/\u003c/span\u003e\u003cspan address=\"https://www.mdpi.com/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e-4923/17/7/913/htm\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eFleșeriu T, Meliț LE, Mărginean CO, Pop AV, Văsieșiu AM (2076) Maternal HIV Infection and Antiretroviral Therapy in Pregnancy: Implications for Vertical Transmission, Fetal Safety, and Long-Term Infant Outcomes. Pathog 2025, Vol 14, Page 818 [Internet]. 2025 Aug 19 [cited 2025 Oct 9];14(8):818. Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.mdpi.com/\u003c/span\u003e\u003cspan address=\"https://www.mdpi.com/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e-0817/14/8/818/htm\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003ePariente G, Leibson T, Carls A, Adams-Webber T, Ito S, Koren G (2016) Pregnancy-Associated Changes in Pharmacokinetics: A Systematic Review. PLoS Med [Internet]. Nov 1 [cited 2025 Oct 9];13(11). Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://pubmed.ncbi.nlm.nih.gov/27802281/\u003c/span\u003e\u003cspan address=\"https://pubmed.ncbi.nlm.nih.gov/27802281/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"Faculty of Pharmacy, Karary University, Khartoum, Sudan","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Pharmacokinetics, Pregnancy, Scopus, Bibliometrics, Drug absorption; Drug distribution; Drug metabolism; Drug excretion, PBPK","lastPublishedDoi":"10.21203/rs.3.rs-7965704/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7965704/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003ePhysiological changes during pregnancy significantly alter drug pharmacokinetics, yet research remains limited due to ethical and methodological challenges. A consolidated overview of the most influential studies is lacking.\u003c/p\u003e\u003ch2\u003eObjective\u003c/h2\u003e\u003cp\u003eThis study aimed to perform a comprehensive bibliometric and thematic analysis of global research on pharmacokinetic changes during pregnancy from 1971 to 2025, identifying trends, influential contributors, emerging themes, and knowledge gaps.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eA bibliometric analysis was conducted on October 8th, 2025 using data extracted from the Scopus database for publications between 1971 and 2025. Performance indicators were analyzed using descriptive statistics and correlation analyses. Bibliometrix (R), VOS viewer, and GraphPad Prism were used for bibliometric mapping, co-authorship networks, and thematic clustering.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eA total of 1,391 publications by 8,192 authors across 511 journals were identified, showing an annual growth rate of 6.18% and 18.89% international collaboration. The United States (13%), Italy (5%), and New Zealand (4%) were leading contributors. Clinical Pharmacokinetics was the top journal, while the \"University of Washington, Seattle, united states\" and \"Wolters Kluwer health - Adis, Auckland, New Zealand\u0026rdquo;, were the most influential institutions. Core keywords included \u0026ldquo;pregnancy,\u0026rdquo; \u0026ldquo;pharmacokinetics,\u0026rdquo; \u0026ldquo;HIV,\u0026rdquo; \u0026ldquo;epilepsy,\u0026rdquo; and \u0026ldquo;therapeutic drug monitoring,\u0026rdquo; with emerging themes such as \u0026ldquo;metabolism\u0026rdquo; and \u0026ldquo;controlled study.\u0026rdquo; Thematic evolution revealed a shift from methodological foundations (1971\u0026ndash;1988) to clinical applications (1989\u0026ndash;2015) and mechanistic approaches (2016\u0026ndash;2025).\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e\u003cp\u003eGlobal research on pharmacokinetic changes during pregnancy has grown steadily, transitioning toward model-informed and mechanistic studies. However, the absence of mature motor themes indicates thematic fragmentation. Strengthening international collaboration, advancing physiologically based pharmacokinetic modeling, and expanding studies across diverse populations and drug classes remain priorities to optimize pharmacotherapy in pregnancy.\u003c/p\u003e","manuscriptTitle":"Global Trends in Pharmacokinetic Changes During Pregnancy: A Bibliometric and Thematic Analysis of Articles Indexed in Scopus (1971-2025)","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-10-29 07:20:41","doi":"10.21203/rs.3.rs-7965704/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"95271d04-c66b-4b92-81a7-6be55ab55c77","owner":[],"postedDate":"October 29th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":56990319,"name":"Pharmacokinetics"}],"tags":[],"updatedAt":"2025-10-29T07:20:41+00:00","versionOfRecord":[],"versionCreatedAt":"2025-10-29 07:20:41","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7965704","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7965704","identity":"rs-7965704","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}