What is the side effect of lithium in pregnancy?

There has been concern that exposure to lithium early in pregnancy may be associated with a marked increase in the risk of Ebstein’s anomaly (a right ventricular outflow tract obstruction defect) in infants and overall congenital cardiac defects, but data are conflicting and limited.

Should lithium be stopped in pregnancy?

If a woman taking lithium becomes pregnant, consider stopping the medicine gradually over 4 weeks if she is well. Explain to her that: stopping medication may not remove the risk of fetal heart malformations. there is a risk of relapse, particularly in the postnatal period, if she has bipolar disorder.

Can taking lithium cause a miscarriage?

Miscarriages occurred in 20.8% of the lithium-exposed pregnancies (16/77), compared with 10.9% of the unexposed pregnancies (40/366) (OR = 2.14; 95% CI: 1.13–4.06). The adjusted odds ratio of miscarriage after lithium use during pregnancy was 2.94 (95% CI: 1.39–6.22).

Does lithium cross the placental barrier?

Lithium freely crosses the placental barrier and lithium concentrations equilibrate between maternal and fetal circulation (Newport et al. 2005). Hence maternal lithium therapy results in fetal lithium exposure.

What birth defects are caused by lithium?

Some studies have suggested that taking lithium in the first trimester is associated with a small increased chance of heart defects, especially a rare heart defect called Ebstein’s anomaly. Ebstein’s anomaly is the abnormal placement of one of the valves that controls blood flow in the heart.

Which teratogenic effect is seen due to lithium?

The results of various studies including cohort, prospective, retrospective and small number case reports indicate that lithium is a “weak” teratogen in humans. The main effects attributable to lithium are, cardiac malformations and babies with increased birth weight.

Can lithium cause birth defects?

However, lithium has also been associated with risks during pregnancy for both the mother and the unborn child. Recent large studies have confirmed the association between first trimester lithium exposure and an increased risk of congenital malformations.

Can you take bipolar medication while pregnant?

Bipolar Medications During Pregnancy. Some women continue taking bipolar medications and have healthy babies. But a few bipolar medications have an increased risk of birth defects in the first trimester.

Which teratogenic effect is seen because of lithium?

What is fetal hydantoin syndrome?

Fetal hydantoin syndrome is a characteristic pattern of mental and physical birth defects that results from maternal use of the anti-seizure (anticonvulsant) drug phenytoin (Dilantin) during pregnancy. The range and severity of associated abnormalities will vary greatly from one infant to another.

Can lithium cause heart defects in babies?

The use of lithium during the first trimester is associated with an increased risk of fetal cardiac malformations, including Ebstein’s, on the order of 1 additional case per 100 live births.

Why is lithium a teratogen?