Chapter 5 112 Reasons for admission in lithium-exposed group (n=7) Psychotropic medication exposure Reasons for admission in non-lithium exposed group (n=15) Psychotropic medication exposure Neurological Severe perinatal asphyxia after shoulder dystocia Hypotonia, hypocapnia (unexplained), feeding difficulties, respiratory distress Clozapine, general anaesthesia during delivery Hypotonia, dyspnoea, perinatal asphyxia, hypoglycaemia Severe neonatal abstinence syndrome Olanzapine, quetiapine Other Atrial flutter Lithium Preventative monitoring for psychoactive medication exposure Quetiapine, oxazepam Choking accident Lithium Figure 5.1 - Neonatal outcomes according to lithium exposure during pregnancy. In the table within Figure 5.1, each half row represents the reason for admission of a single neonate (7 in the lithium exposed group and 15 in the non-exposed group). In the column to the right, we present any psychotropic medication used by the mother. Furthermore, we categorized all reasons for admission to larger groups (prematurity, infectious, respiratory, neurological, and other). Discussion Main findings There was no association between lithium exposure and admission to a neonatal ward with monitoring during the first 28 days after delivery (p = 0.844). One (1%) serious adverse outcome was possibly related to lithium exposure. One in five neonates born to women with BD, independent of lithium exposure, required admission to a neonatal ward with monitoring. Remarkably, pregnant women with BD had high obstetric vulnerability shown by high caesarean section, gestational diabetes, and hypertensive disorders. Our findings that lithium exposure is not associated with more frequent admissions to a neonatal ward with monitoring in a sample of women with BD only is in concordance with findings from a sensitivity analysis in the study of Munk-Olsen et al. (2018).
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