Bipolar Disorder in Pregnancy
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 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 than pregnant women who do not have bipolar disorder.
A 2007 study on bipolar disorder and pregnancy called into question a common belief that pregnancy may have a protective effect for women with bipolar disorder. The study followed 89 women through pregnancy and one year after delivery. When stopping bipolar medications foe the six months before conception to 12 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, 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. It can lead to behaviors like these, which can also harm a baby:
- Poor prenatal care
- Poor nutrition
- A rise in alcohol or tobacco use
- Stress and trouble with attachment
Your doctor may suggest stopping gradually or changing medication. Or you may continue with medication and do regular tests to check on the health of your baby. But whatever you do, don't stop taking medications without first talking with your doctor.
Was your pregnancy unplanned? If so, know that stopping medications suddenly may do more harm than good.
Mood stabilizers. Taking multiple mood-stabilizing drugs has more risks than taking just one. Because of the rare risk for a particular kind of heart defect, lithium is sometimes not recommended during the first three months of pregnancy unless its benefits clearly outweigh the risks. Lithium may be a safer choice than some anticonvulsants. And when lithium is continued after childbirth, it can reduce the rate of relapse from 50% to 10%.