Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Aug 18;13(16):4872.
doi: 10.3390/jcm13164872.

Obstetric Outcomes in Women on Lithium: A Systematic Review and Meta-Analysis

Tommaso Callovini  1   2 , Silvia Montanari  1   2 , Francesca Bardi  1   2 , Sara Barbonetti  1   2 , Sara Rossi  1   2 , Romina Caso  1   2 , Giuseppe Mandracchia  1   2 , Stella Margoni  1   2 , Andrea Brugnami  1   2 , Marco Paolini  3 , Giovanni Manfredi  4 , Luca Lo Giudice  1   2 , Daniele Segatori  1   2 , Andrea Zanzarri  1   2 , Luca Onori  1   2 , Claudia Calderoni  1   2 , Elisabetta Benini  1   2 , Giuseppe Marano  1   2 , Marco Massetti  1   2 , Federica Fiaschè  5 , Federica Di Segni  6 , Delfina Janiri  1   2 , Alessio Simonetti  1   2 , Lorenzo Moccia  1   2 , Flavia Grisoni  1   2 , Sara Ruggiero  1   2 , Giovanni Bartolucci  1   2 , Marco Biscosi  1   2 , Ottavia Marianna Ferrara  1   2 , Evelina Bernardi  1   2 , Leonardo Monacelli  1   2 , Alessandro Michele Giannico  1   2 , Domenico De Berardis  7 , Giulia Battisti  1   2 , Michele Ciliberto  1   2 , Caterina Brisi  1   2 , Francesco Maria Lisci  1   2 , Antonio Maria D'Onofrio  1   2 , Antonio Restaino  1   2 , Luca Di Benedetto  1   2 , Maria Benedetta Anesini  1   2 , Gianluca Boggio  1   2 , Elettra Specogna  1   2 , Arianna Crupi  1   2 , Emanuela De Chiara  1   2 , Emanuele Caroppo  8 , Valentina Ieritano  1   2 , Laura Monti  9 , Daniela Pia Rosaria Chieffo  9   10 , Lucio Rinaldi  1   2 , Giovanni Camardese  1   2 , Ilaria Cuomo  11 , Roberto Brugnoli  1   2 , Georgios D Kotzalidis  1   2 , Gabriele Sani  1   2 , Marianna Mazza  1   2
Affiliations
Review

Obstetric Outcomes in Women on Lithium: A Systematic Review and Meta-Analysis

Tommaso Callovini et al. J Clin Med. .

Abstract

Background/Objectives: Lithium taken during pregnancy was linked in the past with increased risk for foetal/newborn malformations, but clinicians believe that it is worse for newborn children not to treat the mothers' underlying psychiatric illness. We set to review the available evidence of adverse foetal outcomes in women who received lithium treatment for some time during their pregnancy. Methods: We searched four databases and a register to seek papers reporting neonatal outcomes of women who took lithium during their pregnancy by using the appropriate terms. We adopted the PRISMA statement and used Delphi rounds among all the authors to assess eligibility and the Cochrane Risk-of-Bias tool to evaluate the RoB of the included studies. Results: We found 28 eligible studies, 10 of which met the criteria for inclusion in the meta-analysis. The studies regarded 1402 newborn babies and 2595 women exposed to lithium. Overall, the systematic review found slightly increased adverse pregnancy outcomes for women taking lithium for both the first trimester only and any time during pregnancy, while the meta-analysis found increased odds for cardiac or other malformations, preterm birth, and a large size for gestational age with lithium at any time during pregnancy. Conclusions: Women with BD planning a pregnancy should consider discontinuing lithium when euthymic; lithium use during the first trimester and at any time during pregnancy increases the odds for some adverse pregnancy outcomes. Once the pregnancy has started, there is no reason for discontinuing lithium; close foetal monitoring and regular blood lithium levels may obviate some disadvantages of lithium administration during pregnancy.

Keywords: Ebstein’s anomaly; congenital malformations; foetal outcomes; large for gestational age; lithium salts; pregnancy; small for gestational age.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
PRISMA 2020 flow diagram of our selection process, with reasons for exclusion [22]. For more information, visit: http://www.prisma-statement.org/.
Figure 2
Figure 2
Distribution of eligible studies over time.
See this image and copyright information in PMC

References

    1. Cade J.F. Lithium salts in the treatment of psychotic excitement. Med. J. Aust. 1949;2:349–352. doi: 10.5694/j.1326-5377.1949.tb36912.x. - DOI - PubMed
    1. Schou M., Juel-Nielsen N., Stromgren E., Voldby H. The treatment of manic psychoses by the administration of lithium salts. J. Neurol. Neurosurg. Psychiatry. 1954;17:250–260. doi: 10.1136/jnnp.17.4.250. - DOI - PMC - PubMed
    1. Gershon S., Yuwiler A. Lithium ion: A specific psychopharmacological approach to the treatment of mania. J. Neuropsychiatr. 1960;1:229–241. - PubMed
    1. Shorter E. The history of lithium therapy. Bipolar Disord. 2009;11((Suppl. 2)):4–9. doi: 10.1111/j.1399-5618.2009.00706.x. - DOI - PMC - PubMed
    1. Schou M., Goldfield M.D., Weinstein M.R., Villeneuve A. Lithium and pregnancy. I. Report from the Register of Lithium Babies. BMJ. 1973;2:135–136. doi: 10.1136/bmj.2.5859.135. - DOI - PMC - PubMed

LinkOut - more resources