Several authors and guidelines have suggested to decrease or discontinue lithium treatment when in labour in order to minimise lithium side-effects in the neonate (National Collaborating Centre for Mental H When investigating the effect of lithium exposure on obstetric complications in cohort studies it is important to consider that bipolar disorder, the indication for which lithium is often prescribed, is associated with obstetric complications independent of medication. J Psychosom Obstet Gynaecol. Lancet Psychiatry. It is normal to check for heart and other birth defects at these scans. Lithium carbonate and breast-feeding. 1990;301(6761):1111.Bergink V, Kushner SA. 2018;39(3):211–9.Freeman MP, Smith KW, Freeman SA, McElroy SL, Kmetz GE, Wright R, et al. Ebstein’s malformation of the tricuspid valve: genetic and environmental factors. 1990;75(3 Pt 2):504–6.Larsen ER, Damkier P, Pedersen LH, Fenger-Gron J, Mikkelsen RL, Nielsen RE, et al.
1974;2(7880):594–5.Oruch R, Elderbi MA, Khattab HA, Pryme IF, Lund A. Lithium: a review of pharmacology, clinical uses, and toxicity. 2016;13(11):e1002160.Park JM, Sridaromont S, Ledbetter EO, Terry WM. Lithium freely crosses the placental barrier and lithium concentrations equilibrate between maternal and fetal circulation (Newport et al. Report from the register of lithium babies. Not all women manage to breastfeed even if they want to. Antipsychotic use in pregnancy and the risk for congenital malformations. In the case of lithium continuation, fetal anomaly ultrasound including detailed fetal cardiac scanning, should be offered at 20 weeks gestational age. Birth defects usually occur in the beginning of pregnancy (usually in the first trimester) when the baby’s organs are developing. Dev Cell.

Am J Ther. If your lithium level is well controlled with good monitoring it is unlikely that the baby’s Lithium levels will be high. It is important to weigh up the risks and benefits of taking medication in your individual case, including:If you are taking Lithium, you will usually have had a severe mental illness. Am J Psychiatry. Two studies found an increased risk of preterm birth in women with lithium use during pregnancy when compared to controls (Diav-Citrin et al. Lithium during pregnancy. N Engl J Med. J Affect Disord. Iran J Pediatr.

2014;34(3):407–10.Deligiannidis KM, Byatt N, Freeman MP. When lithium therapy is continued during pregnancy, regular antenatal visits are warranted for checking lithium blood levels, evaluation of fetal growth, and for monitoring signs of preterm labour. Toxic effects of lithium carbonate in a mother and newborn infant. We recommend a high-resolution ultrasound with fetal anomaly scanning at 20 weeks. PLoS ONE. Early Hum Dev.

Breastfeeding and lithium. Am J Dis Child. 2017;210:158–65.Boden R, Lundgren M, Brandt L, Reutfors J, Andersen M, Kieler H. Risks of adverse pregnancy and birth outcomes in women treated or not treated with mood stabilisers for bipolar disorder: population based cohort study.
Characteristics of Postpartum Preeclampsia/Eclampsia In our series, patients admitted with a diagnosis of postpartum preeclampsia or eclampsia presented to the ED between 3 and 10 days postpartum, with a median time of 5 days postpartum. Make sure that your obstetrician knows you are taking Lithium so they prescribe safe pain relief during labour and after birth. 2010;12(5):568–78.Blake LD, Lucas DN, Aziz K, Castello-Cortes A, Robinson PN. Cardiol Young.

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