Bipolar Balancing Act During Pregnancy

Pregnant women with bipolar disorder at higher risk for pregnancy or birth complications

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Being pregnant with a psychiatric disorder requires careful balancing of care. Women with bipolar disorder must decide whether or how to treat their condition while pregnant.

In at least one study, being treated or untreated made little difference to pregnancy outcomes.

However, bipolar disorder did increase the risk of certain pregnancy or birth complications. These include early birth, an induction or C section and a small baby.

"Attend all prenatal visits."

The study, led by Robert Bodén, a psychiatrist in the Department of Neuroscience at Uppsala University in Sweden, aimed to find out how bipolar pregnant women fared if their disorder was treated or untreated.

The study involved 332,137 women who gave birth between 2005 and 2009. Of this group, 320 women had been diagnosed as bipolar and had filled a prescription for mood stabilizers while pregnant.

Another 554 women had been diagnosed as bipolar but did not receive medication for their condition while pregnant. These groups were compared to the rest of the pregnant women without bipolar.

For these three groups, researchers looked at early birth rates, types of birth, gestational diabetes rates, babies' birth weights, babies' survival rates and birth defects.

In their calculations, the researchers took into account how old the women were, whether they smoked or drank or used drugs and whether they lived with their partner.

However, the women with bipolar disorder were more likely to smoke, drink alcohol and be overweight.

Therefore, even though the researchers tried to control for those factors, these characteristics might play a small role in the study's findings.

The researchers found that both treated and untreated bipolar women were 50 percent more likely to be induced or plan a cesarean section than non-bipolar women.

While 21 percent of non-bipolar women had an induction or C section, 31 percent of the untreated and 38 percent of the treated bipolar women did.

Bipolar women also had a 50 percent greater chance of having their baby before the 37th week of pregnancy.

While 4.8 percent of non-bipolar women had preemies, 8.1 percent of the treated bipolar women and 7.6 percent of the untreated bipolar women had their babies early.

Women with bipolar disorder were also a little more likely to have babies that were underweight or small for their age.

Overall, the women's pregnancy outcomes did not seem affected by whether the bipolar women were treated or not with two exceptions:

  • The rate of children born with a smaller-than-normal head was a little higher among untreated bipolar women: 3.9 percent compared to 2.3 percent of women without bipolar disorder.
  • Untreated bipolar women were a little more likely to have newborns with hypoglycemia, or low blood sugar.

In general, women with bipolar disorder, treated or not, were at a higher risk for various complications in their pregnancy outcomes.

Women who have bipolar disorder should, therefore, be sure they attend all prenatal visits and regularly consult with their OB/GYN and mental health provider about how to manage their conditions.

The study was published November 7 in the journal BMJ. The research was funded by the Lennanders Foundation, Gillbergska Foundation and Uppsala County Council. The authors declared no conflicts of interest.

Reviewed by: 
Review Date: 
November 8, 2012
Last Updated:
November 11, 2012