Table 3.
Characteristics of 9 included studies
| First author, year of publication | EPHPP rating | Aim of study | Study design | Diagnostic tool | Sample | Pharmaceutic treatment | Length of follow-up | Country |
|---|---|---|---|---|---|---|---|---|
| Akdeniz 2003 [68] | M | To evaluate and emphasise the impact of clinical and psychosocial risk factors associated with pregnancy and/or the postpartum period during the course of BD in women who had given birth | Retro-spective cohort study | BD (DSM-IV). Different types are not reported. | 72 women with BD (252 pregnancies and 160 childbirths) Analysed a sub group: (n = 23): every mood episode that began during pregnancy and in postpartum period following birth at gestation 26 weeks+ | Of women with post-partum episodes (n = 26) 21 had received psychotropic medication. None of the women with post-partum episodes took Lithium during pregnancy. | Pregnancy, birth and up to one month post-partum | Turkey |
| Bodén 2012 [69] | S | To investigate the risks of adverse pregnancy and birth outcomes for treated and untreated bipolar disorder during pregnancy. | Retro-spective case control study | BD (ICD-10 codes F30-31) | A cohort of 332,137 women 2005–2009. Women with a record of at least two BD diagnoses (n = 874), 320 treated with mood stabiliser, 554 untreated, compared with all other women giving birth (n = 331,263) | Treated BD with mood stabiliser (Lithium, antipsycotics or anticonvulsants) | Pregnancy and birth | Sweden |
| Di Florio 2013 [73] | M | To investigate the occurrence and timing of perinatal mood episodes in women with BD-I and BD-II | Retro-spective cohort study | BD-I and BD-II (DSM- IV) | 1212 women (980 with BD-I (1404 births), 232 with BD-II (424 births) | Pharmacotherapy not reported. | Pregnancy, birth and up to one year postpartum | United Kingdom |
| Di Florio 2014 [74] | M | To test the hypothesis that risk of perinatal mood episodes is greater after first pregnancy | Retro-spective cohort study | BD-I and BD-II (DSM-IV) | 1212 women (934 with BD-I (1404 births), 278 with BD-II (424 births) | No details on drug management reported. | Pregnancy, birth and up to one year postpartum | United Kingdom |
| Grof 2000 [75] | M | To examine statistically the clinical course of 28 women with typical bipolar disorder, type I, who became pregnant prior to receiving successful lithium prophylaxis | Retro-spective case/control study | BD (Re-search Diagnostic Criteria, (Spitzer et al. 1978)) | 28 women with BD (56 pregnancies) and no Lithium prophylaxis; 33 childless women with BD (controls) | None had prophy-lactic Lithium during pregnancy, but 4 took Lithium for depression towards end of pregnancy. Women with acute episodes received Lithium as treatment. | Pregnancy, birth and up to 9 months postpartum | A world-wide ethnic popul-ation (the majority from Canada). |
| Jablensky 2005 [67] | M | To determine the frequency, nature, and severity of 25 obstetric complic-ations in women with affective disorders and those with no psychiatric disorder | Case control study | BD (ICD-9 codes 296.0 and 296.2–5) | 763 women with BD, 1,301 pregnancies; 1,831 women (3,129 pregnancies) with no history of mental health difficulties (controls) | No specific information on prescription of medication available. | Pregnancy and birth | Australia |
| Lee 2010 [70] | S | To investigate pregnancy outcomes among women with bipolar disorder, compared with women with no history of mental illness, using nationwide population-based data | Retro-spective case control study | BD (ICD-9-CM codes 295.XX, 296.0X, 296.1X, 296.4X, 296.5X, 296.6X, 296.7X, 296.80 or 296.89) | 337 women with BD; 528,061 women with no history of mental health difficulties (controls) | Information on medical treatment not reported. | Pregnancy and birth | Taiwan |
| Mei-Dan 2015 [71] | S | To evaluate the risk of adverse perinatal outcomes among pregnant women previously hospitalised for BD | Population based case control study | BD (ICD-9, ICD-10CA, DSM-IV) | 1859 women with BD; 3724 women with major depressive disorder (controls); 432,358 women with no mental illness (controls) | No information regarding medical treatment. | Pregnancy, birth and up to 27 days postpartum | Canada (Ontario) |
| Munk-Olsen 2009 [72] | S | To compare mothers and nonmothers to assess whether childbirth increases the risk for psych-iatric readmission and to identify pre-dictors of psychiatric readmission during the first 12 months postpartum. | Population cohort register study, prospec-tively studied | BD (ICD-8 codes 296.19, 296.39 and 298.19. ICD-10 codes F30,F31, F34.0 and F38) | All women born in Denmark between Jan 1, 1955 and July 1, 1990 who were alive on their 15th birthday and who had at least 1 psychiatric admission during the study period: January 1, 1973, through June 30, 2005. Analysis group 2 contained 56 women with bipolar disorder | No data on pharmacological treatment available. | Postpartum up to 12 months | Denmark |
BD Bipolar Disorder, S Strong, M Moderate