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. 2024 Dec;26(8):779-784.
doi: 10.1111/bdi.13481. Epub 2024 Aug 22.

Mood stabilizers for treatment of bipolar disorder in pregnancy and impact on neonatal outcomes

Nalinoë Kernizan  1   2 , Alicia Forinash  1   2 , Abigail Yancey  1   2 , Samuel Kruger  3 , Niraj R Chavan  4 , Katherine Mathews  5
Affiliations

Mood stabilizers for treatment of bipolar disorder in pregnancy and impact on neonatal outcomes

Nalinoë Kernizan et al. Bipolar Disord. 2024 Dec.

Abstract

Introduction: Untreated bipolar disorder in pregnancy is associated with adverse maternal and neonatal outcomes. Despite advances in clinical management, there is concern among obstetric providers and patients about the safety of pharmacological agents for the treatment of bipolar disorder in pregnancy. Recent studies have shown atypical antipsychotics and lamotrigine to have a favorable safety profile; however, little information is published on lurasidone.

Objectives: The objective of this retrospective chart review was to evaluate pregnancy and neonatal outcomes in obstetric patients with bipolar disorder who are untreated, compared to those treated with lurasidone, other atypical antipsychotics, and lamotrigine at a tertiary teaching institution.

Methods: This retrospective cohort study included neonates whose mothers had a diagnosis of bipolar disorder and were referred to the Maternal & Fetal Care Clinic with two documented visits after January 1, 2014, with delivery by October 31, 2017, within an SSM health-system hospital.

Results: In this study, women with untreated bipolar disorder (not on any mood stabilizer) in pregnancy had significantly higher rates of premature delivery and low birth weight compared to women on mood stabilizers of lamotrigine, lurasidone, and other atypical antipsychotics. No difference was observed for pregnancy or neonatal outcomes between patients taking any of the mood stabilizers.

Conclusions: This study suggests that the use of lurasidone, other atypical antipsychotics, and lamotrigine have better neonatal outcomes than untreated bipolar disorder in pregnancy.

Keywords: bipolar; mood stabilizer; obstetrics; pregnancy.

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References

REFERENCES

    1. Bipolar Disorder. National Institutes of Mental Health. [Accessed 2023 June 24]. Available from: https://www.nimh.nih.gov/health/statistics/bipolar‐disorder.shtml. Accessed June 24 2023.
    1. Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age‐of‐onset distributions of dsm‐iv disorders in the national comorbidity survey replication. Arch Gen Psychiatry. 2005;62:593‐602.
    1. American College of Obstetricians and Gynecologists. Treatment and management of mental health conditions during pregnancy and postpartum. Clinical practice guideline No. 5. Obstet Gynecol. 2023;141:1262‐1288.
    1. Boden R, Lundgren M, Brandt L, Reutfors J, Andersen M, Kieler H. Risks of adverse pregnancy and birth outcomes in women treated or not treated with mood stabilizers for bipolar disorder: population based cohort study. BMJ. 2012;345:e7085.
    1. Park Y, Huybrechts KF, Cohen JM, et al. Antipsychotic medication use among publicly insured pregnant women in the United States. Psychiatr Serv. 2017;68(11):1112‐1119. doi:10.1176/appi.ps.201600408