Table 6.

Lithium in pregnancy and lactation

Category D drug

No significant increase of congenital anomalies

Incidence of major malformations – 4% to 12%

Ebstein's anomaly risk 20 to 40 times the risk in general population

Ebstein's anomaly – 0.05% to 0.1%

Premature delivery

Floppy infant syndrome

Transient neurodevelopmental deficits

NDI

Thyroid dysfunctions

Polyhydramnios (rare)

Infant serum one quarter the concentration of lithium in maternal serum

Not many reports of detrimental effects in newborns

Reports of lethargy, hypothermia, hypotonia and T-wave modifications

AAP recommendation – breast-feeding with caution

Serum lithium and CBC monitoring of infant