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dc.contributor.authorFrayne, J.
dc.contributor.authorNguyen, T.
dc.contributor.authorMok, T.
dc.contributor.authorHauck, Yvonne
dc.contributor.authorLiira, H.
dc.identifier.citationFrayne, J. and Nguyen, T. and Mok, T. and Hauck, Y. and Liira, H. 2017. Lithium exposure during pregnancy: outcomes for women who attended a specialist antenatal clinic. Journal of Psychosomatic Obstetrics and Gynecology. 39 (3): pp.211-219.

Introduction: Lithium treatment in pregnancy represents a significant dilemma for women and treating health professionals alike. The complexity of risk-benefit analysis is impacted by limited information. Methods: A cohort study of 33 women with severe mental illness, who were prescribed lithium at any time during the pregnancy, and gave birth between December 2007 and January 2015 at a specialist antenatal clinic in Western Australia. A descriptive comparison for women who continued lithium throughout pregnancy, and those who ceased on discovery of pregnancy was undertaken examining demographic, obstetric, neonatal and psychiatric variables. Results: Women who were prescribed lithium, irrespective of whether they continued or discontinued the medication represented a high risk group obstetrically, with high rates of smoking overall (33%) medical comorbidities (54%) and antenatal complications (88%). Preconception counseling occurred in 33% of the cohort but increased the likelihood of continuing lithium in pregnancy (p?=?.007). Compared to those who ceased lithium, women who remained on lithium through the pregnancy had increased rates of fetal ultrasound abnormalities such as abdominal circumference >90th % (p?=?.005). Psychiatric relapses through the antenatal and immediate postpartum period appeared to be due to a combination of factors. Discussion: Pregnant women with severe mood disorders treated with lithium are a vulnerable, high-risk obstetric population who would benefit from preconception counseling, regular antenatal care in a tertiary center, delivery with neonatal pediatric support and experienced psychiatric management.

dc.titleLithium exposure during pregnancy: outcomes for women who attended a specialist antenatal clinic
dc.typeJournal Article
dcterms.source.titleJournal of Psychosomatic Obstetrics and Gynecology
curtin.departmentSchool of Nursing and Midwifery
curtin.accessStatusFulltext not available

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