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Bipolar Disorder in Pregnancy

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Do you have bipolar disorder and want to become pregnant or are pregnant already? Perhaps you have bipolar disorder and do not want a pregnancy. Be sure to talk with both your obstetrician and psychiatrist about the risks and benefits of bipolar medications and forms of birth control. For some women, a contraceptive injection that is only needed every few months is best.  

If you have bipolar disorder and become pregnant unexpectedly, take note: Stopping your medications suddenly may cause harm to you and your unborn child.

 

Complications of Bipolar Disorder in Pregnancy

Few studies have been done on bipolar disorder and pregnancy, so not enough is known about the risks of untreated bipolar disorder or the risks and benefits of medications during pregnancy. And the factors that lead to relapse during pregnancy are not clear.

Bipolar disorder, however, can worsen during pregnancy. Pregnant women or new mothers with bipolar disorder have seven times the risk of hospital admissions compared to pregnant women who do not have bipolar disorder.

At least one study has called into question the common belief that pregnancy may have a protective effect for women with bipolar disorder. The study followed 89 women through pregnancy and the year after delivery. When stopping bipolar medications for the period from six months before conception to12 weeks after, the women had:

  • Twice the risk of relapse
  • A 50% risk of recurrence within just two weeks, if they stopped suddenly
  • Bipolar symptoms throughout 40% of the pregnancy -- or more than four times that of women who continued their bipolar medications.

 

Bipolar Medications During Pregnancy

Some women continue taking bipolar medications and have healthy babies. But a few bipolar medications have an increased risk of birth defects in the first trimester. That includes defects such as:

  • Neural tube defects
  • Heart defects
  • Developmental delay or neurobehavioral problems

However, you must weigh these risks against the risks of untreated bipolar disorder. 

Untreated depression, for example, has been linked in some studies with low birth weight, or possible negative effects on developing brain structures in the baby. Mood symptoms  can also lead to behaviors like these, which can harm a baby:

  • Poor prenatal care
  • Poor nutrition
  • A rise in alcohol or tobacco use
  • Stress and trouble with attachment
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