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BD and Psychotropic Medication: Impact on Pregnancy

J Affect Disord; ePub 2018 Sep 18; Wisner, et al

Women with bipolar disorder (BD) who are treated with psychotropic drugs in pregnancy differ substantially from women who are not medicated and women who have neither medication exposure nor BD, according to a recent study. Therefore, this makes assessment of reproductive outcomes subject to confounding by indication. This prospective study included 174 mother-infant dyads. Women had BD without psychotropic exposure (BD-NP, n=38), BD with psychotropic treatment (BD-P, n=49), or neither psychotropic exposure nor major mood disorder (Comp, n=87). Maternal characteristics were completed at 20 weeks gestation and evaluated for associations with delivery and birth outcomes. Researchers found:

  • The BD-P, BD-NP, and Comp groups varied significantly on sociodemographic characteristics.
  • Women with BD were more likely to be less educated, unemployed, single, and use tobacco and illicit drugs than women in the Comp group.
  • Compared to women with BD-NP, women with BD-P were more likely to be older and educated.
  • Approximately 10% of all infants were delivered preterm.
  • Infants of mothers with BD-NP had significantly smaller head circumferences than the other groups.

Wisner KL, Sit D, O’Shea K, et al. Bipolar disorder and psychotropic medication: Impact on pregnancy and neonatal outcomes. [Published online ahead of print September 18, 2018]. J Affect Disord. doi:10.1016/j.jad.2018.09.045.