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Lithium placental passage at delivery: an observational study

Published online by Cambridge University Press:  01 September 2022

M.L. Imaz ,
L. Garcia-Esteve ,
M. Torra ,
D. Soy ,
K. Langohr  and
R. Martin-Santos
M.L. Imaz*
Affiliation:
Hospital Clinic, Unit Of Perinatal Mental Health Clínic-bcn. Department Of Psychiatry And Psychology, Barcelona, Spain
L. Garcia-Esteve
Affiliation:
Hospital Clinic, Unit Of Perinatal Mental Health Clínic-bcn. Department Of Psychiatry And Psychology, Barcelona, Spain
M. Torra
Affiliation:
Hospital Clinic, Pharmacology And Toxicology Laboratory, Biochemistry And Molecular Genetics Service, Biomedical Diagnostic Center (cbd), Barcelona, Spain
D. Soy
Affiliation:
Hospital Clinic, Division Of Medicines. Department Of Pharmacy, Barcelona, Spain
K. Langohr
Affiliation:
Universitat Politècnica de Catalunya, Statistics And Operations Research, Barcelona, Spain
R. Martin-Santos
Affiliation:
Hospital Clínic, Department Of Psychiatry And Psychology, Barcelona, Spain
*
*Corresponding author.

Abstract

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Introduction

Lithium is used as a first-line treatment for bipolar disorder during perinatal period. Dosing of lithium can be challenging as a result of pharmacokinetic changes in renal physiology. Frequent monitoring of lithium blood levels during pregnancy is recommended in order remain within the therapeutic window (0.5 to 1.2 mEq/L). Lower neonatal lithium blood level (<0.64 mEq/L) at time of delivery reduces the risk of lithium side effects in the neonate.

Objectives

The aim of the present study was to quantify the rate of lithium placental passage in real word.

Methods

We included a total of 68 mother-infant pairs for which a lithium measurement was performed intrapartum. Lithium serum concentrations were determined by means of an AVL 9180 electrolyte analyzer. The limit of quantification (LoQ) was 0.20 mEq/L and detection limit was 0.10 mEq/L. Pearson analyse was performer to assess the correlation between mother and umbilical cord lithium serum concentrations.

Results

The mean of umbilical cord serum concentration at delivery was 0.57 mEq/L (SD=0.26, range 0,20-1,42). The mean infant-mother lithium ratio at delivery for the 68 pairs was 1.12 (SD=0.24) across a wide range of maternal concentrations (range 0.14-1,40 mEq/L). There was a strong positive correlation between maternal and umbilical cord lithium blood levels (Peearson correlation coefficient 0.948, p<0.001).

Conclusions

Lithium demostrates complete placental passage. This finding is consistent with the results of others studies (Newport 2005; Molenaar 2021).

Disclosure

No significant relationships.

Keywords

Placental passageMother-infant pairLithium blood levelsDelivery
Type
Abstract
Information
European Psychiatry , Volume 65 , Special Issue S1: Abstracts of the 30th European Congress of Psychiatry , June 2022 , pp. S401 - S402
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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