Postpartum affective episodes in womenwith bipolar disorder – monitored by astructured follow-up method

Sammanfattning: Introduction Bipolar disorder (BD) is a psychiatric illness characterised by episodes of depression, hypomania and mania. The first choice of medication treatment for BD is mood stabilizers. However, psychotropic medication has not been approved for use during pregnancy because some drugs have teratogenic and adverse neurodevelopmental effects. However, up to 80 % of women with BD develop some form of postpartum affective episode. Therefore, it is of great interest to investigate the medication treatment for pregnant women with BD. Aim Describe the medication treatment for pregnant women with bipolar disorder and outcome of postpartum affective episodes. Methods This was an observational study, based on retrospective review of medical records of pregnant patients with BD. The patients have visited the clinic of affective disorders, Örebro University Hospital, between the years 2013-2017. The patients were followed during pregnancy and a period of at least 6 months postpartum. Results The rate of postpartum affective episodes in women with bipolar disorder was 8.7%. There was no significant difference (p = 0.36) in outcome between the groups. A greater number of patients with BD type II were included in our cohort. A statistically significant difference (p = 0.05) was observed between the BD type I and type II groups, regarding lithium treatment. Conclusion Our study showed that the rate of postpartum affective episodes was marked lower than expected. Furthermore, except for lithium treatment, there was no statistically significant difference in medication treatment or outcome of postpartum affective episodes between BD type I and II, when monitored by this structured follow-up method.