Risk of adverse pregnancy, delivery and neonatal outcomes associated with bipolar disorder and prenatal use of mood stabilizers: A population-based cohort study.

Autor: Chan JKN; Department of Psychiatry, School of Clinical medicine, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong., Hung SC; Department of Psychiatry, School of Clinical medicine, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong., Lee KCK; Department of Psychiatry, School of Clinical medicine, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong., Cheung KW; Department of Obstetrics and Gynaecology, School of Clinical medicine, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong., Seto MT; Department of Obstetrics and Gynaecology, School of Clinical medicine, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong., Wong CSM; School of Public Health, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong., Lin J; Department of Rehabilitation Sciences, the Hong Kong Polytechnic University, Hong Kong., Chang WC; Department of Psychiatry, School of Clinical medicine, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong; State Key Laboratory of Brain and Cognitive Science, the University of Hong Kong, Hong Kong. Electronic address: changwc@hku.hk.
Jazyk: angličtina
Zdroj: Psychiatry research [Psychiatry Res] 2024 Sep; Vol. 339, pp. 116050. Date of Electronic Publication: 2024 Jun 21.
DOI: 10.1016/j.psychres.2024.116050
Abstrakt: Previous research examining bipolar-disorder (BD) and pregnancy/neonatal outcomes yielded mixed results, were mostly derived from Western countries and rarely delineated effect between disorder and mood-stabilizers. This population-based study identified women age 15-50 years who delivered first/singleton child in 2003-2018 in Hong Kong, utilizing territory-wide medical-record database of public healthcare services. Propensity-score weighted logistic-regression analyses adjusted for confounders were employed to examine risk of adverse pregnancy, delivery and neonatal outcomes associated with BD and mood-stabilizers (lithium, anticonvulsants and antipsychotics). Exploratory unadjusted-analyses were conducted to assess risk for congenital-malformations. Of 465,069 women, 302 had BD-diagnosis, including 168 redeemed ≥ 1 prescription of mood-stabilizers during pregnancy (treated-BD) and 134 gestationally-unexposed to mood-stabilizers (untreated-BD). BD was significantly-associated with increased risk of gestational-diabetes (adjusted-odds-ratio: 1.75 [95 % CI: 1.15-2.70]) and maternal somatic hospitalization ≤ 90 days post-discharge from index-delivery (2.12 [1.19-3.90]). In treatment status-stratified analyses, treated-BD women exhibited significantly-increased rate of gestational-diabetes (2.09 [1.21-3.70]) relative to controls (non-BD and gestationally-unexposed to mood-stabilizers). No significant association of BD or mood-stabilizers with other adverse outcomes was observed. Overall, our findings indicate that BD and mood-stabilizers are not associated with most adverse pregnancy, delivery and neonatal outcomes. Further research clarifying comparative safety of individual mood-stabilizing agents on pregnancy/neonatal outcomes is required.
Competing Interests: Declaration of competing interest The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.
(Copyright © 2024 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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