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Posted on Jun 22, 2018, 2 p.m.
Exposure to lithium after first trimester has been shown to be associated with elevated risk of major congenital fetuses malformation in the largest study to examine birth defect risk of lithium exposed babies, as published in The Lancet Psychiatry.
7.4% more babies exposed to lithium during the first trimester have been found by Mount Sinai researchers to have experienced major malformations, neonatal hospital readmission risk was 27.5% higher as well. Pregnancy complications or other delivery outcomes were not associated with lithium exposure.
Congenital malformation risks examined included heart defects and pregnancy complications in a meta-analysis of data collected from 727 lithium exposed pregnancies which were compared with 21,397 control pregnancies in mothers with mood disorders who were not taking lithium. Data was collected from Sweden, Netherlands, Denmark, United Kingdom, USA, and Canada. Delivery outcomes and neonatal hospital readmission within 28 days of birth were also measured.
Bipolar disorder patients are widely prescribed lithium as first line treatment of the condition which affects approximately 2% of the worldwide population, as it helps to prevent severe depression and mania. Bipolar disorder is more often treated with antipsychotic drugs rather than lithium within the USA.
Women who are pregnant or considering conceiving should be made aware of the potential risks if their are taking lithium. There is also a very high risk of relapse for mental illness during pregnancy and postpartum periods bipolar women also need to take into consideration. Lithium is well documented for reducing relapse during perinatal periods, important clinical considerations must be taken in regards to lowering dose, restarting after first trimester, or to restart after pregnancy during postpartum for baby and mother safety alike.
Materials provided by The Mount Sinai Hospital / Mount Sinai School of Medicine.
Note: Content may be edited for style and length.
Journal Reference:
Trine Munk-Olsen, Xiaoqin Liu, Alexander Viktorin, Hilary K Brown, Arianna Di Florio, Brian M D'Onofrio, Tara Gomes, Louise M Howard, Hind Khalifeh, Holly Krohn, Henrik Larsson, Paul Lichtenstein, Clare L Taylor, Inge Van Kamp, Richard Wesseloo, Samantha Meltzer-Brody, Simone N Vigod, Veerle Bergink. Maternal and infant outcomes associated with lithium use in pregnancy: an international collaborative meta-analysis of six cohort studies. The Lancet Psychiatry, 2018; DOI: 10.1016/S2215-0366(18)30180-9
