Neonatal admission after lithium use in pregnant women with bipolar disorders 115 during pregnancy and comorbid psychiatric medication use may increase this vulnerability and alter birth outcomes11. In our sample, 11.1% of all women with BD smoked during all trimesters of pregnancy. Although the percentage of women smoking in the lithium and non-lithium exposed groups were comparable, smoking is a potential confounder with regards to neonatal morbidity. Preterm birth was not associated to lithium exposure in our study (p = 1.00), in contrast to previous research3. Although we did not find a difference in large for gestational age neonates, we found higher birth weight in lithium-exposed neonates and higher percentile birth weight compared to non-exposed neonates in line with previous studies9. Conclusions The results of this study show that one in five neonates was admitted to a neonatal ward with monitoring. Obstetric risks of mothers with BD were high and overall neonatal admissions were frequent. However, lithium exposure in itself was not a reason for admission to a neonatal ward with monitoring. We argue that special measures with regards to lithium use might be abundant, and advise joint observation of mothers with BD and their offspring in a nursery (level 1 care) to promote motherinfant bonding. Future studies should further explore factors related to the mental disorder in relation to obstetric vulnerability and adverse neonatal outcomes in women with BD.
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