untreated bipolar disorder and pregnancy

The management of bipolar disorder in pregnancy is challenging; there is an increase in the rate of relapse of bipolar disorder in the perinatal period and treatment decisions are complex as clinicians are required to weigh up the risks of untreated illness versus unwanted treatment effects on both the mother and the developing fetus. A recent study from Wisner and colleagues looks at pregnancy outcomes in women with bipolar disorder, comparing women who maintain treatment to those who elect to discontinue medications during pregnancy. The study suggests that while exposure to mood stabilizers during pregnancy may carry some risk, this exposure to medication is not the sole reason for adverse pregnancy outcomes in women with bipolar disorder, and it is important to note that the illn, ess itself– or behaviors associated with having the illness– may also have a negative effect on pregnancy outcomes. Instead, a number of genetic and environmental factors are thought to act as triggers. This prospective study included 174 mother-infant dyads: women with bipolar disorder without psychotropic medication exposure (BD-NP, n?=?38), women with bipolar disorder who received psychotropic medication treatment (BD-P, n?=?49), and women without mood disorder and no medication exposure (Comp, n?=?87). In a linked research paper (doi:10.1136/bmj.e7085), Bodén and colleagues analysed the risks for the fetus associated with treated and untreated bipolar disorder during pregnancy. DESIGN: Population based cohort study using data from national health registers. Several of the medications used as mood stabilizers, specifically lithium and valproic acid, carry some teratogenic risk. Risks of adverse pregnancy and birth outcomes in women treated or not treated with mood stabilisers for bipolar disorder: Population based cohort study. Moreover, infants of women with untreated bipolar disorder were at increased risk of microcephaly and neonatal hypoglycaemia. In studies of pregnant women with unipolar depression, it has been shown that untreated psychiatric illness in the mother may have a negative impact on pregnancy outcomes, influencing the length of gestation and birthweight. Few studies have been done on bipolar disorder and pregnancy, so not enough is known about the risks of untreated bipolar disorder or the risks and benefits of Bipolar disorder, however, can worsen during pregnancy. Objective: Bipolar disorder affects 2-8% of pregnant and postpartum women; untreated illness is associated with poor outcomes. FRIDAY, Nov. 9 (HealthDay News) -- Women with treated and untreated bipolar disorder are more likely to give birth prematurely -- before 37 weeks -- and have other pregnancy and birth complications, according to a new study.. Women planning a pregnancy must be properly counseled regarding the risks of treatment versus the risks associated with the untreated psychiatric illness in the mother, and the woman’s health care provider plays an important role in weighing these individual risks and selecting the best options for treatment. Keep up with the latest news in women’s mental health and our research. These findings are somewhat different from a larger Swedish study (Boden, et al 2012), which concluded that bipolar disorder in women, whether treated or not, was associated with worse pregnancy outcomes. Comparing the three groups, there were no significant differences in terms of the following outcomes: gestational age, APGAR scores?
untreated bipolar disorder and pregnancy 2021