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Lithium Use in First Trimester Linked to Greater Risk of Birth Defects

By jeremyc | July 3, 2018

Lithium is used for treating bipolar disorder. Taking lithium in the first trimester increases the risk the infant’s risk of developing serious congenital malformations, like heart defects. However, stopping the medication in certain cases might also prove risky.

Lithium use in the first trimester can mean greater risk of congenital malformations for the baby. However, a new study finds the risk is not as big as previously expected.

In this study, the researchers did meta-analysis of data obtained from 727 pregnancies exposed to lithium. The researchers compared it with the data of more than 21,000 pregnancies in those women who had a mood disorder but didn’t use lithium.

The rate of major malformations among babies of mother who had a mood disorder but take lithium during pregnancy was 4 percent. In comparison, 7 percent of babies born to mother taking lithium developed major malformations.

One reason why previous research hinted at a greater risk of congenital malformations in infants born of mothers on lithium might be because of small sample size. Compared to previous studies, this study looked at a much greater sample size.

While lithium exposure increases the baby’s risk of developing major malformations, stopping it might not be the best option in case the mother has a severe bipolar disorder. Stopping treatment in such a case might put both the mother and the child at a huge risk.

The researchers suggest that whether to discontinue lithium in the first trimester or not is a call that psychiatrist needs to take after weighing both the pros and cons. Lithium is much better tolerated by the fetus in the second and third trimester, and so its use during these times is considered relatively safer.

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