van Hoe K, De Fruyt J, Ceulemans M, Smits A, Lannoo L, Hompes T
Tijdschr Psychiatr. 2021;63(7):557-564.
Lithium use during peripartum requires careful consideration due to a risk of teratogenic effects, adverse side effects and risk of neonatal complications. However, given the effectiveness of lithium, use during the peripartum period may be indicated.
To provide an overview of the current evidence regarding the clinical use of lithium during peripartum, including risk of relapse in case of (dis)continuation and evolution of lithium levels.
A review was performed in the Medline and ScienceDirect database.
Ten studies were included. Six studies concerned the risk of relapse in case of (dis)continuation of lithium during the peripartum. Four studies concerned the evolution of lithium levels throughout the peripartum. Lithium discontinuation during pregnancy leads to an increased risk of relapse during pregnancy and postpartum. At the same dose, lithium levels are lower than preconceptual in all trimesters.
Risk and benefits of lithium use during the peripartum should be carefully considered, if possible prior to conception. Close monitoring of maternal lithium levels and renal function is necessary due to significant fluctuations during peripartum.
由于存在致畸作用、不良副作用以及新生儿并发症风险，围产期使用锂盐需要谨慎考虑。然而，鉴于锂盐的有效性，围产期可能仍需使用。
概述围产期锂盐临床应用的现有证据，包括（停）用锂盐后的复发风险以及锂盐水平的变化。
在Medline和ScienceDirect数据库中进行了一项综述。
纳入了十项研究。六项研究关注围产期（停）用锂盐后的复发风险。四项研究关注整个围产期锂盐水平的变化。孕期停用锂盐会导致孕期及产后复发风险增加。在相同剂量下，锂盐水平在所有孕期均低于孕前水平。
围产期使用锂盐的风险和益处应仔细权衡，若可能，应在受孕前进行。由于围产期锂盐水平波动较大，因此有必要密切监测母体锂盐水平和肾功能。
