Observational studyBipolar disorders2021
Management of lithium dosing around delivery: An observational study.
Observational study in Bipolar disorders, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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.
Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Canadian Network for Mood and Anxiety Treatments 2024 Clinical Practice Guideline for the Management of Perinatal Mood, Anxiety, and Related Disorders: Guide de pratique 2024 du Canadian Network for Mood and Anxiety Treatments pour le traitement des troubles de l'humeur, des troubles anxieux et des troubles connexes périnatals.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2025Guideline
- Management of Lithium in Pregnancy and Lactation: An Individualized Approach.Current psychiatry reports · 2026Review
- Review
- Lithium: current state of the art and future directions.International journal of bipolar disorders · 2024Review
- Obstetric Outcomes in Women on Lithium: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2024Review
- Striking the Balance: Bipolar Disorder in the Perinatal Period.Focus (American Psychiatric Publishing) · 2024Review
- Reproductive Psychiatry: Postpartum Depression is Only the Tip of the Iceberg.Focus (American Psychiatric Publishing) · 2024Article
- High lithium concentration at delivery is a potential risk factor for adverse outcomes in breastfed infants: a retrospective cohort study.International journal of bipolar disorders · 2023Article
- Early Postnatal Outcome and Care after in Utero Exposure to Lithium: A Single Center Analysis of a Belgian Tertiary University Hospital.International journal of environmental research and public health · 2022Article
- Course of Illness and Treatment Updates for Bipolar Disorder in the Perinatal Period.Current psychiatry reports · 2022Review
- Management of lithium dosing around delivery: An observational study.Bipolar disorders · 2021Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesRecommendations 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.
methodsIn 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.
resultsThere 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.
conclusionBased 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.
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