{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:31:24Z","timestamp":1773016284343,"version":"3.50.1"},"reference-count":25,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,9,16]],"date-time":"2024-09-16T00:00:00Z","timestamp":1726444800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,9,16]],"date-time":"2024-09-16T00:00:00Z","timestamp":1726444800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neuropsychopharm Rep"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The current literature on the effects of clozapine on pregnancy is limited, and no cases of pregnant Japanese women have been reported. Decreased variability in the fetal heart rate due to clozapine exposure has been reported in countries other than Japan, but its association with serum concentrations of clozapine has not been documented. In this case, a 29\u2010year\u2010old Japanese primipara with treatment\u2010resistant schizophrenia taking clozapine 250\u2009mg\/day experienced pregnancy. The pregnancy progressed without complications. At 40\u2009weeks and 2\u2009days of gestation, the patient developed premature rupture of membranes, and decreased variability in the fetal heart rate and variable deceleration were observed, leading to an emergency cesarean section. The neonate had no congenital malformations, metabolic disorders, seizures, floppy infant syndrome, leukopenia, or neutropenia. Serum concentrations of clozapine and norclozapine (N\u2010desmethylclozapine), measured in the mother and in the neonate immediately after birth, suggested that clozapine and norclozapine were transported to the fetus during pregnancy. Based on these observations, the present case suggests that high fetal serum concentrations of clozapine and norclozapine may affect fetal heart rate. This case report concludes that, with careful monitoring, Japanese women taking clozapine can deliver successfully and emphasizes the importance of monitoring serum clozapine concentrations and fetal cardiac function throughout pregnancy, with particular attention to the later stages.<\/jats:p>","DOI":"10.1002\/npr2.12486","type":"journal-article","created":{"date-parts":[[2024,9,17]],"date-time":"2024-09-17T15:39:52Z","timestamp":1726587592000},"page":"852-856","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Clozapine treatment of a Japanese patient during pregnancy: Effect on fetal heart rate"],"prefix":"10.1002","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-6539-1932","authenticated-orcid":false,"given":"Shunya","family":"Aoki","sequence":"first","affiliation":[{"name":"Pharmaceutical Department Japanese Red Cross Narita Hospital  Narita\u2010shi Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katsutoshi","family":"Takada","sequence":"additional","affiliation":[{"name":"Pharmaceutical Department Japanese Red Cross Narita Hospital  Narita\u2010shi Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tatsuru","family":"Sugama","sequence":"additional","affiliation":[{"name":"Pharmaceutical Department Japanese Red Cross Narita Hospital  Narita\u2010shi Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitsugi","family":"Kimiwada","sequence":"additional","affiliation":[{"name":"Pharmaceutical Department Japanese Red Cross Narita Hospital  Narita\u2010shi Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tatsuya","family":"Hoshino","sequence":"additional","affiliation":[{"name":"Nursing Department Japanese Red Cross Narita Hospital  Narita\u2010shi Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takaoki","family":"Kaneko","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Japanese Red Cross Narita Hospital  Narita\u2010shi Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shintaro","family":"Obata","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Japanese Red Cross Narita Hospital  Narita\u2010shi Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuhiro","family":"Ota","sequence":"additional","affiliation":[{"name":"Department of Neonatology Japanese Red Cross Narita Hospital  Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoshi","family":"Toishi","sequence":"additional","affiliation":[{"name":"Department of Neonatology Japanese Red Cross Narita Hospital  Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaori","family":"Koike","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Japanese Red Cross Narita Hospital  Narita\u2010shi Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hirokazu","family":"Akada","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Japanese Red Cross Narita Hospital  Narita\u2010shi Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takahisa","family":"Saiga","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Japanese Red Cross Narita Hospital  Narita\u2010shi Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shigeki","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Japanese Red Cross Narita Hospital  Narita\u2010shi Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,9,16]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.21r13952"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gyobfe.2012.07.004"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.2515\/therapie\/2014214"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0020-7292(02)00276-X"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1479-828X.2009.01017.x"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00737-019-00985-1"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/acps.12742"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1055\/a-1625-6388"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2018.00264"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/070674370404901213"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.5016"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v58n0806f"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2004-832689"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.154.5.718b"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2004.08.030"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00737-016-0670-0"},{"key":"e_1_2_11_18_1","first-page":"197","article-title":"Adverse event profile and safety of clozapine","volume":"6","author":"Dev VJ","year":"1995","journal-title":"Rev Contemp Pharmacother"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.genhosppsych.2007.11.002"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.289.6455.1345"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/jog.15438"},{"key":"e_1_2_11_22_1","volume-title":"Williams Obstetrics","author":"Cunningham FG","year":"2022"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/jog.14472"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/da.10037"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.151.6.945"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1517\/17425251003677755"}],"container-title":["Neuropsychopharmacology Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/npr2.12486","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/npr2.12486","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/npr2.12486","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T23:37:13Z","timestamp":1773013033000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/npr2.12486"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,16]]},"references-count":25,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024,12]]}},"alternative-id":["10.1002\/npr2.12486"],"URL":"https:\/\/doi.org\/10.1002\/npr2.12486","archive":["Portico"],"relation":{},"ISSN":["2574-173X","2574-173X"],"issn-type":[{"value":"2574-173X","type":"print"},{"value":"2574-173X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,16]]},"assertion":[{"value":"2024-06-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-16","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}