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Pregnant Women With Bipolar Disorder May Have Higher Risk of Premature Birth

FRIDAY, Nov. 9 (HealthDay News) -- Women with treated and untreated bipolar disorder are more likely to give birth prematurely -- before 37 weeks -- and have other pregnancy and birth complications, according to a new study.

The study was published online Nov. 8 in the journal BMJ.

People with bipolar disorder, sometimes called manic depression, experience extreme mood swings. Treatment with mood-stabilizing drugs can help keep a patient's mood within a normal range.

Previous research has suggested, however, that these drugs may be linked to pregnancy and birth complications, while little is known about the risk of such problems in women with untreated bipolar disorder, according to a journal news release.

This Swedish study included 320 mothers with treated bipolar disorder and more than 550 mothers with untreated bipolar disorder. They were compared to mothers who did not have the disorder.

Women with treated and untreated bipolar disorder were more likely to have cesarean delivery, instrumental delivery (use of a vacuum or forceps) and a non-spontaneous start to delivery than those without bipolar disorder. The risk was 37.5 percent for treated women, about 31 percent for untreated women and 21 percent for those without bipolar disorder.

Treated and untreated mothers also were more likely to give birth prematurely than women without bipolar disorder: 8.1 percent, 7.6 percent and 4.8 percent, respectively.

Babies born to untreated mothers were more likely to have a small head and to have episodes of low blood sugar levels than those born to mothers without bipolar disorder, said the researchers from Uppsala University and the Karolinska Institute.

There were not major differences between treated and untreated mothers, and mood-stabilizing drugs probably are not the only reason for the increased risk of pregnancy and birth complications in mothers with bipolar disorder, the researchers concluded.

The question is not "to treat or not to treat?" but how to provide the best possible treatment, Dr. Salvatore Gentile, a mental-health expert in Italy, wrote in an accompanying editorial.

Because no drug is without risks, doctors cannot hope to offer patients a "safe choice," but merely a "less harmful" one, he noted. Doctors must counsel patients about the risks of treatment versus the risks associated with the untreated mental-health disorder, Gentile said.

Although the study found an association between bipolar disorder and pregnancy and birth complications, it did not prove a cause-and-effect relationship.

More information

The U.S. National Institute of Mental Health has more about bipolar disorder.

-- Robert Preidt

SOURCE: BMJ, news release, Nov. 8, 2012

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