Abstract
We have previously described the association between maternal Li therapy during pregnancy and fetal macrosomia (Ped Res 17(4):304A, 1983). This study reviews the records of 241 infants reported to the Register of Lithium Babies between 1962-1978. All infants were included in calculating mortality statistics. Gestational age (GA), birthweight (BW), sex, Li dose and duration of therapy were analyzed in 180 infants. Premature delivery occurred in 39% of the pregnancies. Mothers of premature infants were treated with higher daily Li doses during the 1st and 2nd trimester than mothers of term infants (1.2 ± .6 gm vs. .9 ± .5 gm (1st trim.), p <.001 and 1.0 ± .8 gm vs .8 ± .5 gm (2nd trim.), p=.06). Macrosomia (BW > 90th %tile for GA) was identified in 36% of the infants with a higher frequency in infants born prematurely than in those born at term (59% vs. 26%). The degree of macrosomia was significantly more pronounced in premature infants than in full term infants (129 ± 23 vs. 106 ± 18, % mean BW for GA, p<.0001). Perinatal mortality was 8.3% (projected 83 deaths/1000 live births) and included 8 stillbirths. Premature delivery accounted for 42% of the perinatal deaths. This study demonstrates that maternal use of Li (particularly greater than 1 gram daily in the 1st and 2nd trimester) during pregnancy constitutes a significant risk of premature delivery and fetal macrosomia. Prenatal management of these high risk pregnancies should include close monitoring for excessive intrauterine growth and premature labor.
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Yoder, M., Belik, J., Lannon, R. et al. INFANTS OF MOTHERS TREATED WITH LITHIUM (Li) DURING PREGNANCY HAVE AN INCREASED INCIDENCE OF PREMATURITY, MACROSOMIA AND PERINATAL MORTALITY. Pediatr Res 18 (Suppl 4), 163 (1984). https://doi.org/10.1203/00006450-198404001-00420
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DOI: https://doi.org/10.1203/00006450-198404001-00420