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PW01-14 - Lithium Placental Passage and Perinatal Outcome: Clinical Management During Late Pregnancy

Published online by Cambridge University Press:  17 April 2020

M.L. Imaz
Affiliation:
Perinatal Psychiatry Programme, Institute Clinic of Neuroscience (ICN), Hospital Clinic- Maternitat, Barcelona, Spain
M. Torra
Affiliation:
Biochemistry and Molecular Genetic, Biomedical Diagnostic Centre (CDB), Hospital Clínic, Barcelona, Spain
C.C. Santos-Lozano
Affiliation:
Perinatal Psychiatry Programme, Institute Clinic of Neuroscience (ICN), Hospital Clinic- Maternitat, Barcelona, Spain Psychiatry, Hospital Universitario UANL ‘Dr. José E. González’, Monterrey, Mexico, Spain
A. Torres
Affiliation:
Perinatal Psychiatry Programme, Institute Clinic of Neuroscience (ICN), Hospital Clinic- Maternitat, Barcelona, Spain
C. Marqueta
Affiliation:
Psychiatry, Consorci Sanitari de Terrassa, Tarrasa, Spain
J.M. Hernández
Affiliation:
Neonatal Screening, Biomedical Diagnostic Centre (CDB), Hospital Clínic, Barcelona, Spain
J.M. Pérez
Affiliation:
Neonatology, Barcelona, Spain
I. Teixido
Affiliation:
Obstetric, Institute Clínic of Gynecology, Obstetric and Neonatology (ICGON), Hospital Clínic-Maternitat, Barcelona, Spain
R. Martín-Santos
Affiliation:
Psychiatry, Institute Clínic of Neuroscience (ICN), Hospital Clínic, Barcelona, Spain IDIBAPS, Barcelona, Spain CIBERSAM, Barcelona, Spain
L. García-Esteve
Affiliation:
Perinatal Psychiatry Programme, Institute Clinic of Neuroscience (ICN), Hospital Clinic- Maternitat, Barcelona, Spain IDIBAPS, Barcelona, Spain

Abstract

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Introduction

Despite lithium has been used for the last 50 years as a maintenance treatment for bipolar disorder during pregnancy, there is limited information about perinatal clinical outcomes from fetal exposure to lithium.

Objectives

  1. 1. To quantify the rate of lithium placental passage

  2. 2. To assess any association between plasma concentration of lithium at delivery and perinatal outcome.

Methods

Observational and prospective study. Subjects: Women in maintenance treatment with lithium, being attended during pregnancy at the Perinatal Psychiatry Programme of Hospital Clínic (Barcelona, Spain) between 2007 and 2009. Procedure: We assessed sociodemographical data; dose/day of lithium carbonate; other drugs doses; plasmatic concentration of lithium carbonate in maternal blood intrapartum and in the umbilical cord; obstetrical maternal complications; gestational age at delivery; weight at delivery; Apgar scores; congenital malformations; hospital stays, infant serum concetrations of thyroid-stimulating hormone.

Results

Eight mother-child diads. Mean age of the mother (SD): 32.1 (4,7); 100% caucasian and married. Mean dose of maternal lithium (SD): 675mg (237,5mg). Premature rupture of membranes (%):25. Gestational mean age (in weeks) (SD): 39,9 (1). Birth weight (SD) : 3625gr (451,2gr); Mean Apgar1min (SD): 8,38 (1,1); Mean Apgar5min (SD): 9,75 (0,4). Loss of fetal intrapartum wellness (%): 12,5. Days of hospitalization (mean) (SD):9,5(16,6). Lithium plasmatic concentration (mEq/L), mean (SD): maternal 0,45(0,1), umbilical cord 0,33(0,1), lithium ratio uc/m 0,93 (0,3); infant TSH μU/mL mean (SD): 4,9(4,6).

Conclusions

Lithium placental passsage was 0,93 (0,63-1,07). ≤At umbilical cord lithium levels ≤ 0.60 mEq/L, we didn't have any preterm deliveries, low birth weight newborns, nor neonatal complications.

Type
Affective disorders / Unipolar depression / Bipolar disorder
Copyright
Copyright © European Psychiatric Association 2010
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