Lithium dosing strategies during pregnancy and the postpartum period.
Br J Psychiatry
; 211(1): 31-36, 2017 07.
Article
em En
| MEDLINE
| ID: mdl-28673946
ABSTRACT
BackgroundLithium is challenging to dose during pregnancy.AimsTo provide guidance for dosing lithium during pregnancy.MethodRetrospective observational cohort study. Data on lithium blood level measurements (n = 1101), the daily lithium dose, dosing alterations/frequency and creatinine blood levels were obtained from 113 pregnancies of women receiving lithium treatment during pregnancy and the postpartum period.ResultsLithium blood levels decreased in the first trimester (-24%, 95% CI -15 to -35), reached a nadir in the second trimester (-36%, 95% CI -27 to -47), increased in the third trimester (-21%, 95% CI -13 to -30) and were still slightly increased postpartum (+9%, 95% CI +2 to +15). Delivery itself was not associated with an acute change in lithium and creatinine blood levels.ConclusionsWe recommend close monitoring of lithium blood levels until 34 weeks of pregnancy, then weekly until delivery and twice weekly for the first 2 weeks postpartum. We suggest creatinine blood levels are measured to monitor renal clearance.
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
5_ODS3_mortalidade_materna
Base de dados:
MEDLINE
Assunto principal:
Esquema de Medicação
/
Compostos de Lítio
Tipo de estudo:
Guideline
/
Observational_studies
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Risk_factors_studies
Limite:
Female
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Humans
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Pregnancy
Idioma:
En
Revista:
Br J Psychiatry
Ano de publicação:
2017
Tipo de documento:
Article