Women with mood swings likely to have premature births

By Robert Zavuga

Women with bipolar disorder, a disease characterised by episodes of mood swings, are more likely to give birth prematurely — before 37 weeks — and have other pregnancy and birth complications, according to a new study.

According to a study published in October 2012, by the British Medical Journal, people with bipolar disorder, sometimes called manic depression, experience extreme mood swings.

These mood swings range from extreme depression (sense of feeling sad) to over activity (being too talkative and restless).

Quite often, treatment with mood stabilising drugs can help keep a patient’s mood within a normal range, and many have benefited from treatment.

Previous research has suggested, however, that these drugs used in treatment of bipolar disorder may be linked to pregnancy and birth complications, while little is known about the risk of such problems in women with untreated bipolar disorder, according to a journal news release.

This Swedish study included 320 mothers with treated bipolar disorder and more than 550 mothers with untreated bipolar disorder. They were compared to mothers who did not have the disorder.

It was found out that, women with bipolar disorder were more likely to have caesarean delivery, instrumental delivery (use of a vacuum or forceps) and a nonspontaneous start to delivery than those without bipolar disorder.

Babies born to mothers who are not on treatment were more likely to have a small head and to have episodes of low blood sugar levels than those born to mothers without bipolar disorder, said the researchers from Uppsala University and the Karolinska Institute.

There were not major differences between treated and untreated mothers, and moodstabilising drugs probably are not the only reason for the increased risk of pregnancy and birth complications in mothers with bipolar disorder, the researchers concluded.

The question here is not “to treat or not to treat?”, but how to provide the best possible treatment, Dr. Salvatore Gentile, a mental-health expert in Italy, wrote in an accompanying editorial.

Because there is no drug without risks, doctors cannot hope to offer patients a “safe choice”, but merely a “less harmful” one, he noted. Doctors must counsel patients about the risks of treatment versus the risks associated with the untreated mental-health disorder, Gentile said.

Although the study found an association between bipolar disorder and pregnancy and birth complications, it did not prove a cause-and-effect relationship.

It is, therefore, important to include reproductive health services in the mental healthcare package such that we reduce on the complications of pregnancy and childbirth for our psychiatric mothers.