Lithium exposure during pregnancy: outcomes for women who attended a specialist antenatal clinic

Introduction: Lithium treatment in pregnancy represents a significant dilemma for women and treating health professionals alike. The complexity of risk-benefit analysis is impacted by limited information. Methods: A cohort study of 33 women with severe mental illness, who were prescribed lithium at...

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Main Authors: Frayne, J., Nguyen, T., Mok, T., Hauck, Yvonne, Liira, H.
Format: Journal Article
Published: 2017
Online Access:http://hdl.handle.net/20.500.11937/54943
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author Frayne, J.
Nguyen, T.
Mok, T.
Hauck, Yvonne
Liira, H.
author_facet Frayne, J.
Nguyen, T.
Mok, T.
Hauck, Yvonne
Liira, H.
author_sort Frayne, J.
building Curtin Institutional Repository
collection Online Access
description Introduction: Lithium treatment in pregnancy represents a significant dilemma for women and treating health professionals alike. The complexity of risk-benefit analysis is impacted by limited information. Methods: A cohort study of 33 women with severe mental illness, who were prescribed lithium at any time during the pregnancy, and gave birth between December 2007 and January 2015 at a specialist antenatal clinic in Western Australia. A descriptive comparison for women who continued lithium throughout pregnancy, and those who ceased on discovery of pregnancy was undertaken examining demographic, obstetric, neonatal and psychiatric variables. Results: Women who were prescribed lithium, irrespective of whether they continued or discontinued the medication represented a high risk group obstetrically, with high rates of smoking overall (33%) medical comorbidities (54%) and antenatal complications (88%). Preconception counseling occurred in 33% of the cohort but increased the likelihood of continuing lithium in pregnancy (p?=?.007). Compared to those who ceased lithium, women who remained on lithium through the pregnancy had increased rates of fetal ultrasound abnormalities such as abdominal circumference >90th % (p?=?.005). Psychiatric relapses through the antenatal and immediate postpartum period appeared to be due to a combination of factors. Discussion: Pregnant women with severe mood disorders treated with lithium are a vulnerable, high-risk obstetric population who would benefit from preconception counseling, regular antenatal care in a tertiary center, delivery with neonatal pediatric support and experienced psychiatric management.
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spelling curtin-20.500.11937-549432018-10-18T01:51:23Z Lithium exposure during pregnancy: outcomes for women who attended a specialist antenatal clinic Frayne, J. Nguyen, T. Mok, T. Hauck, Yvonne Liira, H. Introduction: Lithium treatment in pregnancy represents a significant dilemma for women and treating health professionals alike. The complexity of risk-benefit analysis is impacted by limited information. Methods: A cohort study of 33 women with severe mental illness, who were prescribed lithium at any time during the pregnancy, and gave birth between December 2007 and January 2015 at a specialist antenatal clinic in Western Australia. A descriptive comparison for women who continued lithium throughout pregnancy, and those who ceased on discovery of pregnancy was undertaken examining demographic, obstetric, neonatal and psychiatric variables. Results: Women who were prescribed lithium, irrespective of whether they continued or discontinued the medication represented a high risk group obstetrically, with high rates of smoking overall (33%) medical comorbidities (54%) and antenatal complications (88%). Preconception counseling occurred in 33% of the cohort but increased the likelihood of continuing lithium in pregnancy (p?=?.007). Compared to those who ceased lithium, women who remained on lithium through the pregnancy had increased rates of fetal ultrasound abnormalities such as abdominal circumference >90th % (p?=?.005). Psychiatric relapses through the antenatal and immediate postpartum period appeared to be due to a combination of factors. Discussion: Pregnant women with severe mood disorders treated with lithium are a vulnerable, high-risk obstetric population who would benefit from preconception counseling, regular antenatal care in a tertiary center, delivery with neonatal pediatric support and experienced psychiatric management. 2017 Journal Article http://hdl.handle.net/20.500.11937/54943 10.1080/0167482X.2017.1337743 restricted
spellingShingle Frayne, J.
Nguyen, T.
Mok, T.
Hauck, Yvonne
Liira, H.
Lithium exposure during pregnancy: outcomes for women who attended a specialist antenatal clinic
title Lithium exposure during pregnancy: outcomes for women who attended a specialist antenatal clinic
title_full Lithium exposure during pregnancy: outcomes for women who attended a specialist antenatal clinic
title_fullStr Lithium exposure during pregnancy: outcomes for women who attended a specialist antenatal clinic
title_full_unstemmed Lithium exposure during pregnancy: outcomes for women who attended a specialist antenatal clinic
title_short Lithium exposure during pregnancy: outcomes for women who attended a specialist antenatal clinic
title_sort lithium exposure during pregnancy: outcomes for women who attended a specialist antenatal clinic
url http://hdl.handle.net/20.500.11937/54943