Management of lithium dosing around delivery: An observational study.
delivery
infant
lithium
neonate
postpartum
pregnancy
Journal
Bipolar disorders
ISSN: 1399-5618
Titre abrégé: Bipolar Disord
Pays: Denmark
ID NLM: 100883596
Informations de publication
Date de publication:
02 2021
02 2021
Historique:
pubmed:
12
6
2020
medline:
27
4
2021
entrez:
12
6
2020
Statut:
ppublish
Résumé
Recommendations on lithium dosing around delivery vary, with several guidelines suggesting that lithium should be discontinued prior to delivery. We aimed to evaluate the validity of these recommendations by investigating 1) maternal lithium blood level changes following delivery, and 2) the association between neonatal lithium blood levels at delivery and neonatal outcomes. In this retrospective observational cohort study, we included women with at least one lithium blood level measurement during the final week of pregnancy and the first postpartum week. For aim 2, we included a subcohort of women with neonates for whom neonatal lithium blood levels (obtained from the umbilical cord or a neonatal vein puncture within 24 hours of delivery) were available. There were a total of 233 maternal lithium blood level measurements; 55 (23.6%) in the week before delivery and 178 (76.4%) in the week after. There was no association between time and lithium blood level/dose ratio (Pearson correlation coefficient -0.03, P = .63). Additionally, we included a total of 29 neonates for whom a lithium measurement was performed within 24 hours postpartum. Maternal and neonatal lithium blood levels were strongly correlated. We observed no associations between neonatal lithium blood levels at delivery and neonatal outcomes. Based on our findings, we do not recommend lowering the dosage or discontinuation of lithium prior to delivery. Stable dosing can prevent subtherapeutic lithium serum levels, which is especially important in the postpartum period when relapse risks are highest.
Identifiants
pubmed: 32526071
doi: 10.1111/bdi.12955
pmc: PMC7891390
doi:
Substances chimiques
Lithium
9FN79X2M3F
Types de publication
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
49-54Informations de copyright
© 2020 The Authors. Bipolar Disorders published by John Wiley & Sons Ltd.
Références
Am J Psychiatry. 2016 Feb 1;173(2):117-27
pubmed: 26514657
J Affect Disord. 2018 Mar 1;228:216-221
pubmed: 29274567
J Psychopharmacol. 2016 Jun;30(6):495-553
pubmed: 26979387
Curr Psychiatry Rep. 2016 Feb;18(2):13
pubmed: 26781551
J Clin Psychopharmacol. 2014 Apr;34(2):244-55
pubmed: 24525634
Lancet Psychiatry. 2018 Aug;5(8):644-652
pubmed: 29929874
N Engl J Med. 2017 Jun 8;376(23):2245-2254
pubmed: 28591541
J Affect Disord. 2017 Aug 15;218:394-397
pubmed: 28501739
J Affect Disord. 2000 Dec;61(1-2):31-9
pubmed: 11099738
Int J Bipolar Disord. 2018 Dec 2;6(1):26
pubmed: 30506447
Bipolar Disord. 2021 Feb;23(1):49-54
pubmed: 32526071
Aust N Z J Psychiatry. 2015 Dec;49(12):1087-206
pubmed: 26643054
J Conserv Dent. 2010 Oct;13(4):265-71
pubmed: 21217956
Lancet. 2013 May 11;381(9878):1672-82
pubmed: 23663953
BMJ Open. 2017 Mar 1;7(3):e015738
pubmed: 28249852
Am J Psychiatry. 2005 Nov;162(11):2162-70
pubmed: 16263858
Br J Psychiatry. 2017 Jul;211(1):31-36
pubmed: 28673946
Curr Psychiatry Rep. 2018 Mar 17;20(3):20
pubmed: 29549608
Am J Psychiatry. 2020 Jan 1;177(1):76-92
pubmed: 31623458
Arch Womens Ment Health. 2018 Aug;21(4):475-479
pubmed: 29549439