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

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.