• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • Write for us
  • Contact us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Cardiology

Lithium during pregnancy linked to modest increase in cardiac malformations

byMatthew GrowdonandDayton McMillan
June 13, 2017
in Cardiology, Obstetrics, Pediatrics, Public Health
Reading Time: 3 mins read
0
Share on FacebookShare on Twitter

1. There has been concern about the linkage between lithium use during pregnancy and a risk of cardiac malformations, specifically Ebstein’s anomaly, with varying levels of association found in prior studies.

2. Using Medicaid data from over 1 million pregnancies, exposure to lithium during the first trimester was associated with an additional 1 case of cardiac malformation per 100 live births compared to a lithium-free scenario.

Evidence Rating Level: 2 (Good)

Study Rundown: Since the publishing of results from the International Register of Lithium Babies in the 1970s, there has been widespread concern about the linkage between lithium use during pregnancy and a risk of infant cardiac defects. The results from follow-up case reports and smaller case-control and controlled cohort studies have been mixed. At the same time, lithium remains a first-line therapy for women with bipolar disorder of reproductive age in the United States. In this large retrospective cohort study involving Medicaid data, the authors investigated the risk of cardiac malformations in the offspring of women taking lithium during their first trimester, compared to control groups of unexposed infants and infants exposed to lamotrigine. The results indicate an increase in the adjusted risk of cardiac malformations among infants exposed to lithium in the first trimester, compared to unexposed and lamotrigine exposed infants. There was a dose-dependent increase in this relative risk. Lithium exposure during the first trimester was associated with an additional 1 cardiac malformation case per 100 live births relative to lithium-free pregnancies.

This study lends credence to the linkage between maternal lithium use during the first trimester and increased risk of congenital heart abnormalities, especially right ventricular outflow tract obstruction defects. The reported risk is statistically significant but much more modest than previous studies. The study draws strength from its large size and propensity matching, but given its nonrandomized and database approach is subject to residual confounding by unmeasured variables and the possibility of misclassification bias.

Click to read the study, published in NEJM

Relevant Reading: Valproic acid monotherapy in pregnancy and major congenital malformations

RELATED REPORTS

Presence of second midwife during the second active stage of labour reduces the risk of severe perineal trauma

Pregnant patients with epilepsy may benefit from increased doses of anticonvulsant medications

Low-to-Moderate caffeine intake during pregnancy is not associated with increased risk of maternal cardiometabolic complications

In-Depth [retrospective cohort]: This retrospective cohort study assessed Medicaid data for 1 325 563 pregnancies between 2000 and 2010. Exposure was defined as having at least one filled prescription for lithium during the first trimester; the primary reference group was women without lithium or lamotrigine fillings during the 3 months prior to pregnancy or the first trimester. The primary outcome was infant cardiac malformations, with secondary outcomes of major congenital malformations. Covariates accounting for medical and social factors were used to derive a propensity-matched cohort. In the primary analysis, the adjusted risk ratio for cardiac malformations among lithium-exposed infants was 1.65 (95%CI 1.02-2.68) compared to unexposed infants and 2.25 (95%CI 1.17-4.34) compared to lamotrigine-exposed infants. The adjusted risk-ratio for right ventricular outflow tract obstruction defects was 2.66 (95%CI 1.00-7.06) for lithium compared to unexposed infants. There was a dose-response relationship noted between lithium prescribed during the first trimester and increasing cardiac malformation risk. There was differential incomplete data for important confounding covariates, such as obesity, smoking, and alcohol use orders, with this data more often missing in the group receiving lithium therapy; this would probably bias the adjusted risk estimates upward.

Image: CC/Wiki

©2017 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

Tags: lithiumpregnancy complications
Previous Post

Tofacitinib may be an effective treatment for nail psoriasis

Next Post

Complete dissection does not increase survival for sentinel-node positive melanoma patients

RelatedReports

Women electing abortion more likely to be victims of domestic violence
Chronic Disease

Presence of second midwife during the second active stage of labour reduces the risk of severe perineal trauma

April 7, 2022
USPSTF finds insufficient evidence for screening for iron deficiency anemia during pregnancy
Neurology

Pregnant patients with epilepsy may benefit from increased doses of anticonvulsant medications

February 16, 2022
Caffeine affects teen boys, girls differently
Obstetrics

Low-to-Moderate caffeine intake during pregnancy is not associated with increased risk of maternal cardiometabolic complications

November 9, 2021
Mental retardation associated with IVF treatment
Emergency

Use of in vitro fertilization, twin pregnancies and advanced maternal age independently associated with adverse maternal outcomes

September 13, 2021
Next Post
Women with pregnancy-associated melanoma at greater risk of metastasis, recurrence

Complete dissection does not increase survival for sentinel-node positive melanoma patients

Factors contributing to parents providing alcohol sips to adolescents

2 Minute Medicine Rewind June 12, 2017

PCI not superior to medical therapy alone in stable coronary disease: The COURAGE study

New standardized score identifies patients who should be treated with shorter duration dual-antiplatelet therapy

License Our Award-Winning Physician-Written Medical News and Visual Abstracts

2 Minute Medicine is the leading authoritative medical news licensing service, and the only with reports written by practicing doctors.

LICENSE CONTENT

2MM+ Premium Access

No ads & unlimited access to all current reports, over 9000 searchable archived reports, visual abstracts, Weekly Rewinds, and the online edition of The Classics Series™ textbook.

Subscription Options
2 Minute Medicine

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • Momelotinib reduces symptom burden compared to danazol in patients with myelofibrosis
  • Machine renal perfusion reduces delayed graft function after transplantation
  • COVID-19 mRNA vaccines are safe and effective in children aged 5 to 11 years
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

Want more physician-written
medical news?

Join over 10 million yearly readers and numerous companies. For healthcare professionals
and the public.

Subscribe for free today!

Subscription options