Abstract
BACKGROUND: The objective of the present study is to review the literature regarding the management of fertile patients under lithium treatment for bipolar disorder and to report the experience of our Teratology Information Service over the past thirteen years in managing women treated with lithium during preconception, pregnancy and breastfeeding. METHODS: This research focuses on a selective review of the literature and a retrospective survey has been carried out on fertile women under lithium treatment who called our service at A. Gemelli University Hospital in Rome from May 2002 to December 2015. RESULTS: A total of 140 women under lithium treatment called our TIS. A complete follow-up has been performed on 34 patients: 29 called during pregnancy and 5 called during preconception. None of the patients called during breastfeeding, while half of the patients were taking concomitant drugs during pregnancy. One major cardiac malformation (hypoplastic left heart syndrome) has been reported. No minor malformations have been detected. Twenty-one patients delivered a living child, with one premature neonate. Two patients underwent voluntary interruption of pregnancy and six patients had early spontaneous abortion. In one patient, intrauterine growth retardation occurred, but with no adverse neonatal outcomes. Four neonates experienced transient respiratory distress at birth. Two children developed mild to severe language delay, but normal motor development. CONCLUSIONS: Lithium treatment in fertile women is a very delicate topic, where risks and benefits of discontinuing therapy when women plan to become pregnant should be accurately evaluated. Thorough peri-conceptional counselling is crucial for the outcome of pregnancy and for maternal health status during preconception, gestation and breastfeeding.
| Original language | English |
|---|---|
| Pages (from-to) | 261-267 |
| Number of pages | 7 |
| Journal | Minerva Ginecologica |
| Volume | 70 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Jun 1 2018 |
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Keywords
- Lithium
- Preconception care
- Pregnancy
ASJC Scopus subject areas
- Obstetrics and Gynaecology
Cite this
Managing fertile women under lithium treatment : The challenge of a Teratology Information Service. / Neri, Caterina; De Luca, Carmen; D'oria, Luisa; Licameli, Angelo; Nucci, Marta; Pellegrino, Marcella; Caruso, Alessandro; De Santis, Marco.
In: Minerva Ginecologica, Vol. 70, No. 3, 01.06.2018, p. 261-267.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Managing fertile women under lithium treatment
T2 - The challenge of a Teratology Information Service
AU - Neri, Caterina
AU - De Luca, Carmen
AU - D'oria, Luisa
AU - Licameli, Angelo
AU - Nucci, Marta
AU - Pellegrino, Marcella
AU - Caruso, Alessandro
AU - De Santis, Marco
PY - 2018/6/1
Y1 - 2018/6/1
N2 - BACKGROUND: The objective of the present study is to review the literature regarding the management of fertile patients under lithium treatment for bipolar disorder and to report the experience of our Teratology Information Service over the past thirteen years in managing women treated with lithium during preconception, pregnancy and breastfeeding. METHODS: This research focuses on a selective review of the literature and a retrospective survey has been carried out on fertile women under lithium treatment who called our service at A. Gemelli University Hospital in Rome from May 2002 to December 2015. RESULTS: A total of 140 women under lithium treatment called our TIS. A complete follow-up has been performed on 34 patients: 29 called during pregnancy and 5 called during preconception. None of the patients called during breastfeeding, while half of the patients were taking concomitant drugs during pregnancy. One major cardiac malformation (hypoplastic left heart syndrome) has been reported. No minor malformations have been detected. Twenty-one patients delivered a living child, with one premature neonate. Two patients underwent voluntary interruption of pregnancy and six patients had early spontaneous abortion. In one patient, intrauterine growth retardation occurred, but with no adverse neonatal outcomes. Four neonates experienced transient respiratory distress at birth. Two children developed mild to severe language delay, but normal motor development. CONCLUSIONS: Lithium treatment in fertile women is a very delicate topic, where risks and benefits of discontinuing therapy when women plan to become pregnant should be accurately evaluated. Thorough peri-conceptional counselling is crucial for the outcome of pregnancy and for maternal health status during preconception, gestation and breastfeeding.
AB - BACKGROUND: The objective of the present study is to review the literature regarding the management of fertile patients under lithium treatment for bipolar disorder and to report the experience of our Teratology Information Service over the past thirteen years in managing women treated with lithium during preconception, pregnancy and breastfeeding. METHODS: This research focuses on a selective review of the literature and a retrospective survey has been carried out on fertile women under lithium treatment who called our service at A. Gemelli University Hospital in Rome from May 2002 to December 2015. RESULTS: A total of 140 women under lithium treatment called our TIS. A complete follow-up has been performed on 34 patients: 29 called during pregnancy and 5 called during preconception. None of the patients called during breastfeeding, while half of the patients were taking concomitant drugs during pregnancy. One major cardiac malformation (hypoplastic left heart syndrome) has been reported. No minor malformations have been detected. Twenty-one patients delivered a living child, with one premature neonate. Two patients underwent voluntary interruption of pregnancy and six patients had early spontaneous abortion. In one patient, intrauterine growth retardation occurred, but with no adverse neonatal outcomes. Four neonates experienced transient respiratory distress at birth. Two children developed mild to severe language delay, but normal motor development. CONCLUSIONS: Lithium treatment in fertile women is a very delicate topic, where risks and benefits of discontinuing therapy when women plan to become pregnant should be accurately evaluated. Thorough peri-conceptional counselling is crucial for the outcome of pregnancy and for maternal health status during preconception, gestation and breastfeeding.
KW - Lithium
KW - Preconception care
KW - Pregnancy
UR - http://www.scopus.com/inward/record.url?scp=85048783938&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85048783938&partnerID=8YFLogxK
U2 - 10.23736/S0026-4784.18.04190-4
DO - 10.23736/S0026-4784.18.04190-4
M3 - Article
C2 - 29845825
AN - SCOPUS:85048783938
VL - 70
SP - 261
EP - 267
JO - Minerva Ginecologica
JF - Minerva Ginecologica
SN - 0026-4784
IS - 3
ER -