No link exists between lithium use in pregnancy and certain pregnancy complications or adverse delivery outcomes, suggests a recent meta-analysis published in The Lancet Psychiatry. However, there was a higher risk of hospital readmission and congenital malformations, suggested the authors.

In an evaluation of 6 international cohorts, pregnant women who took lithium did not have increased pregnancy complications including pre-eclampsia, diabetes during pregnancy, fetal distress, and post-partum hemorrhage, or adverse labor and delivery outcomes, including cesarean section, preterm birth, low birthweight or small-for-gestational-age infants. An increased risk of major congenital malformations with lithium use in the first trimester, and increased risk of neonatal readmissions linked to lithium were; however, noted.

Among women with bipolar disorder, lithium can reduce the risk of relapse during pregnancy and post-partum. The results thus highlight that considering the effectiveness of lithium in reducing relapse in the perinatal period, it would be important to consider whether to continue the drug in a lower dose during the first trimester or to restart it after the first trimester or immediately postpartum. The authors have also stated that the results suggest that the absolute risk of malformations is smaller than that reported in earlier studies.