Evidence map›Paper›PMID 30506447›Full record

ReviewInternational journal of bipolar disorders2018

Lithium during pregnancy and after delivery: a review.

Eline M P Poels, Hilmar H Bijma, Megan Galbally, Veerle Bergink

Open access · goldAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in International journal of bipolar disorders, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
45citing papers in PubMed, 3 pooled it
8.0field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

45 citing papers in PubMed, 3 syntheses or guidelines pooled it, 119 citations in OpenAlex.

  1. Guideline
  2. Pooled it
  3. Lamotrigine in the maintenance treatment of bipolar disorder.The Cochrane database of systematic reviews · 2021
    Pooled it
  4. Review
  5. Article
  6. Article
  7. Article
  8. Review
  9. Review
  10. Review
  11. Article
  12. Review
  13. Review
  14. Depression Treatment in Pregnancy: Is It Safe, or Is It Not?International journal of environmental research and public health · 2024
    Review
  15. Striking the Balance: Bipolar Disorder in the Perinatal Period.Focus (American Psychiatric Publishing) · 2024
    Review
  16. Review
  17. Article
  18. Article
  19. Postpartum psychosis: A proposed treatment algorithm.Journal of psychopharmacology (Oxford, England) · 2023
    Review
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 3 institutions in 3 countries.

Eline M P PoelsDepartment of Psychiatry, Erasmus University Medical Centre Rotterdam, Rotterdam, The Netherlands.
Hilmar H BijmaDepartment of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus University Medical Centre Rotterdam, Rotterdam, The Netherlands.
Megan GalballySchool of Psychology and Exercise Science, Murdoch University, Murdoch, Australia.
Veerle BerginkDepartment of Psychiatry, Erasmus University Medical Centre Rotterdam, Rotterdam, The Netherlands. Veerle.bergink@mssm.edu.
Erasmus University Rotterdam · NLIcahn School of Medicine at Mount Sinai · USMurdoch University · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Lithium is an effective treatment in pregnancy and postpartum for the prevention of relapse in bipolar disorder. 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. Importantly, the risk estimates from these studies are lower than previously reported. Tapering of lithium during the first trimester could be considered but should be weighed against the risks of relapse. There seems to be no association between lithium use and pregnancy or delivery related outcomes, but more research is needed to be more conclusive. When lithium is prescribed during pregnancy, lithium blood levels should be monitored more frequently than outside of pregnancy and preferably weekly in the third trimester. We recommend a high-resolution ultrasound with fetal anomaly scanning at 20 weeks. Ideally, delivery should take place in a specialised hospital where psychiatric and obstetric care for the mother is provided and neonatal evaluation and monitoring of the child can take place immediately after birth. When lithium is discontinued during pregnancy, lithium could be restarted immediately after delivery as strategy for relapse prevention postpartum. Given the very high risk of relapse in the postpartum period, a high target therapeutic lithium level is recommended. Most clinical guidelines discourage breastfeeding in women treated with lithium. It is highly important that clinicians inform and advise women about the risks and benefits of remaining on lithium in pregnancy, if possible preconceptionally. In this narrative review we provide an up-to-date overview of the literature on lithium use during pregnancy and after delivery leading to clinical recommendations.

Indexed as

Bipolar disorderBreastfeedingCongenital malformationsDeliveryLithiumNeurodevelopmentPerinatalPostpartum psychosisPregnancyReview

Identifiers

PMID30506447
PMCPMC6274637
OpenAlexW2900822583

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.