Lithium use during pregnancy was associated with an increased risk of preterm birth and large for gestational age infants.
Although the last decade has brought increased awareness of and interest in postpartum mood and anxiety disorders, our understanding of the etiology of this most severe form of postpartum mental illness remains elusive.
Long-term behavioral follow-up of children exposed to mood stabilizers and antidepressants: A look forward – ObGynNews
Dr. Lee S. Cohen, Director of the Ammon-Pinizzotto Center for Women's Mental Health at Massachusetts General Hospital, recently shared his insights on the long-term behavioral follow-up of children exposed to mood stabilizers and antidepressants with Ob.Gyn News on August 16,
Prevalence of Bipolar Disorder and Bipolar-Spectrum Mood Episodes During Pregnancy and the Postpartum Period in Perinatal Women
A recent review and meta-analysis found that upwards of 20% of women with no history of psychiatric illness experience their first bipolar-spectrum mood episode during the perinatal period.
While data are limited regarding AEDs and breastfeeding, it appears that none of the AEDs are excreted at high levels into the breast milk, nor have they been associated with high rates of adverse events in the nursing infant.
Second-generation antipsychotic medications associated with high metabolic risk (quetiapine, olanzapine, and clozapine) were associated with increased risk of gestational diabetes; other antipsychotics were not.
Prenatal exposure to antipsychotic medications was not associated with increased risk of neurodevelopmental disorders in offspring.
Prospective Data on the Use of Newer Antipsychotics During Pregnancy: No Increase in Risk of Malformations
The most recent publication from the National Pregnancy Registry focuses on overall risk of malformations associated with the class of antipsychotic medications.
Because women with bipolar disorder are at high risk for relapse during the postpartum period, we typically recommend that women continue treatment with lithium throughout the postpartum period. While this intervention clearly decreases risk for postpartum psychiatric illness, the use of lithium while breastfeeding presents certain challenges.
Women with bipolar disorder (BD) are at extremely high risk for postpartum psychiatric illness, including postpartum psychosis. While the American College of Obstetrics and Gynecology now recommends that all women be screened for depression [...]