Some Neonatal Risks for Lithium Exposure in Pregnancy

WEDNESDAY, June 20, 2018 (HealthDay News) — In utero lithium exposure is associated with an increased risk for neonatal readmission and major malformations, according to a meta-analysis published online June 18 in The Lancet Psychiatry.

Trine Munk-Olsen, Ph.D., from Aarhus University in Denmark, and colleagues conducted a meta-analysis of primary data to examine the correlation between in utero lithium exposure and risk of pregnancy complications, delivery outcomes, neonatal morbidity, and congenital malformations. Data were included from six study sites with 727 lithium-exposed pregnancies and 21,397 reference pregnancies in mothers with a mood disorder who were not exposed to lithium.

The researchers found that there was no correlation for lithium exposure with any of the predefined pregnancy complications or delivery outcomes. Compared with the reference group, lithium-exposed pregnancies had an increased risk for neonatal readmission (27.5 versus 14.3 percent; pooled adjusted odds ratio, 1.62). An increased risk of major malformations was seen in association with lithium exposure in the first trimester (7.4 versus 4.3 percent; pooled adjusted odds ratio, 1.71). More lithium-exposed children had major cardiac malformations, although the difference was not statistically significant.

“Treatment decisions must weigh the potential for increased risks, considering both effect sizes and the precision of the estimates, in particular associated with first-trimester lithium use against its effectiveness at reducing relapse,” the authors write.

Two authors disclosed financial ties to the pharmaceutical industry.

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