Prescribing Lithium During Pregnancy Requires Careful Balancing of Benefits, Risks

The risk of giving birth to a child with birth defects may be slightly higher in women with bipolar disorder who take lithium compared with those who do not take lithium, suggests ameta-analysis inAJP in Advance. However, these slight risks may be outweighed by the dangers to mother and child of relapse of illness episodes (either depressive or manic), the authors of the analysis caution.“Pregnancy should not be considered an absolute contraindication to lithium prescription, given the relatively small increase in risk for any malformation or cardiac malformations, and given that such events, fortunately, remain rare,” wrote Michele Fornaro, M.D., Ph.D., of the University of Nap les Federico II School of Medicine and colleagues. In comparison, women with bipolar disorder who are not in treatment may experience frequent relapse of mood episodes during pregnancy and the postpartum period. These episodes themselves can harm the health of the mother and the fetus or newborn.Fornaro and colleagues compiled data from 29 studies that assessed the efficacy and safety outcomes of lithium treatment during pregnancy and the postpartum period. They found that lithium exposure was not associated with any risk of preterm birth or low birth weight. Compared with women who were not prescribed lithium, however, those who took lithium any time during pregnancy had 1.81 times greater odds of giving birth to a child with a congenital defect and 1.86 times greater odds of giving birth to a ch...
Source: Psychiatr News - Category: Psychiatry Tags: ajp in advance bipolar disorder cardiac birth defect congenital defect lithium meta-analysis Michele Fornaro miscarriage relapse Source Type: research