Lithium prescribing during pregnancy: a UK primary care database study.

<h4>Background</h4>Women taking lithium must decide whether to continue the medication if they conceive or plan to conceive. Little is known about the extent of prescribing of lithium during pregnancy.<h4>Aims</h4>To determine: 1) the prevalence of lithium prescribing during...

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Main Authors: Rachel L McCrea, Irwin Nazareth, Stephen J W Evans, David P J Osborn, Vanessa Pinfold, Phil J Cowen, Irene Petersen
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2015-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0121024&type=printable
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author Rachel L McCrea
Irwin Nazareth
Stephen J W Evans
David P J Osborn
Vanessa Pinfold
Phil J Cowen
Irene Petersen
author_facet Rachel L McCrea
Irwin Nazareth
Stephen J W Evans
David P J Osborn
Vanessa Pinfold
Phil J Cowen
Irene Petersen
author_sort Rachel L McCrea
collection DOAJ
description <h4>Background</h4>Women taking lithium must decide whether to continue the medication if they conceive or plan to conceive. Little is known about the extent of prescribing of lithium during pregnancy.<h4>Aims</h4>To determine: 1) the prevalence of lithium prescribing during pregnancy and 2) to assess whether pregnancy is associated with discontinuation of lithium.<h4>Method</h4>First, we identified women receiving any lithium prescriptions before and during pregnancy using The Health Improvement Network (THIN) primary care database. Subsequently, we used a Kaplan-Meier plot to compare time to last prescription in women prescribed lithium continuously three months before pregnancy and a comparison group of non-pregnant women. Finally, we described the characteristics of the women prescribed lithium in pregnancy.<h4>Results</h4>Very few women were prescribed lithium during pregnancy; out of 458,761 pregnancies, we identified 47 (0.01%) in which lithium was prescribed after the 6th week of pregnancy (when the pregnancy was likely to be known). In our study of discontinuation, we found pregnant women were more likely to stop lithium than those who were not pregnant. Of the 52 women who were being continuously prescribed lithium three months before pregnancy, only 17 (33%) continued receiving prescriptions beyond the 6th week of pregnancy. However, most of these 17 women continued treatment throughout pregnancy.<h4>Conclusions</h4>Pregnancy was strongly associated with discontinuation of lithium. Further evidence on the risks of lithium is needed so that women can weight these against the risk of a deterioration in maternal mental health.
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spelling doaj-art-b53cc6e99e664ea197e07805660952ac2025-08-20T02:34:13ZengPublic Library of Science (PLoS)PLoS ONE1932-62032015-01-01103e012102410.1371/journal.pone.0121024Lithium prescribing during pregnancy: a UK primary care database study.Rachel L McCreaIrwin NazarethStephen J W EvansDavid P J OsbornVanessa PinfoldPhil J CowenIrene Petersen<h4>Background</h4>Women taking lithium must decide whether to continue the medication if they conceive or plan to conceive. Little is known about the extent of prescribing of lithium during pregnancy.<h4>Aims</h4>To determine: 1) the prevalence of lithium prescribing during pregnancy and 2) to assess whether pregnancy is associated with discontinuation of lithium.<h4>Method</h4>First, we identified women receiving any lithium prescriptions before and during pregnancy using The Health Improvement Network (THIN) primary care database. Subsequently, we used a Kaplan-Meier plot to compare time to last prescription in women prescribed lithium continuously three months before pregnancy and a comparison group of non-pregnant women. Finally, we described the characteristics of the women prescribed lithium in pregnancy.<h4>Results</h4>Very few women were prescribed lithium during pregnancy; out of 458,761 pregnancies, we identified 47 (0.01%) in which lithium was prescribed after the 6th week of pregnancy (when the pregnancy was likely to be known). In our study of discontinuation, we found pregnant women were more likely to stop lithium than those who were not pregnant. Of the 52 women who were being continuously prescribed lithium three months before pregnancy, only 17 (33%) continued receiving prescriptions beyond the 6th week of pregnancy. However, most of these 17 women continued treatment throughout pregnancy.<h4>Conclusions</h4>Pregnancy was strongly associated with discontinuation of lithium. Further evidence on the risks of lithium is needed so that women can weight these against the risk of a deterioration in maternal mental health.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0121024&type=printable
spellingShingle Rachel L McCrea
Irwin Nazareth
Stephen J W Evans
David P J Osborn
Vanessa Pinfold
Phil J Cowen
Irene Petersen
Lithium prescribing during pregnancy: a UK primary care database study.
PLoS ONE
title Lithium prescribing during pregnancy: a UK primary care database study.
title_full Lithium prescribing during pregnancy: a UK primary care database study.
title_fullStr Lithium prescribing during pregnancy: a UK primary care database study.
title_full_unstemmed Lithium prescribing during pregnancy: a UK primary care database study.
title_short Lithium prescribing during pregnancy: a UK primary care database study.
title_sort lithium prescribing during pregnancy a uk primary care database study
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0121024&type=printable
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