Odds of pregnancy and birth outcomes by maternal bipolar disorder and treatment with mood stabilisers during pregnancy
| Variables | Total No | No (%) with outcome | Odds ratio (95% CI) | P value | |
|---|---|---|---|---|---|
| Unadjusted | Adjusted* | ||||
| Gestational diabetes: | |||||
| No bipolar disorder | 331 263 | 5536 (1.7) | 1 (reference) | 1 (reference) | 0.96 |
| Untreated bipolar disorder | 554 | 10 (1.8) | 1.06 (0.56 to 2.02) | 1.01 (0.53 to 1.94) | |
| Treated bipolar disorder† | 320 | 6 (1.9) | 1.18 (0.55 to 2.56) | 1.12 (0.52 to 2.43) | |
| Instrumental delivery‡: | |||||
| No bipolar disorder | 331 263 | 81 730 (24.7) | 1 (reference) | 1 (reference) | <0.001 |
| Untreated bipolar disorder | 554 | 183 (33.0) | 1.52 (1.27 to 1.82) | 1.49 (1.24 to 1.81) | |
| Treated bipolar disorder† | 320 | 109 (34.1) | 1.52 (1.20 to 1.92) | 1.39 (1.09 to 1.79) | |
| Caesarean delivery: | |||||
| No bipolar disorder | 331 263 | 55 692 (16.8) | 1 (reference) | 1 (reference) | <0.001 |
| Untreated bipolar disorder | 554 | 130 (23.5) | 1.52 (1.25 to 1.85) | 1.45 (1.18 to 1.78) | |
| Treated bipolar disorder† | 320 | 82 (25.6) | 1.69 (1.32 to 2.16) | 1.56 (1.20 to 2.03) | |
| Non-spontaneous start of delivery: | |||||
| No bipolar disorder | 331 263 | 68 533 (20.7) | 1 (reference) | 1 (reference) | <0.001 |
| Untreated bipolar disorder | 554 | 171 (30.9) | 1.69 (1.4 to 2.03) | 1.57 (1.30 to 1.90) | |
| Treated bipolar disorder† | 320 | 120 (37.5) | 2.28 (1.82 to 2.87) | 2.12 (1.68 to 2.67) | |
| Preterm birth, <37 weeks’ gestation: | |||||
| No bipolar disorder | 331 263 | 15 785 (4.8) | 1 (reference) | 1 (reference) | 0.03 |
| Untreated bipolar disorder | 554 | 42 (7.6) | 1.64 (1.20 to 2.24) | 1.48 (1.08 to 2.03) | |
| Treated bipolar disorder† | 320 | 26 (8.1) | 1.75 (1.18 to 2.62) | 1.50 (1.01 to 2.24) | |
| Apgar score <7 at 5 min§: | |||||
| No bipolar disorder | 331 263 | 3541 (1.1) | 1 (reference) | 1 (reference) | 0.48 |
| Untreated bipolar disorder | 554 | 11 (2.0) | 1.87 (1.03 to 3.4) | 1.56 (0.85 to 2.86) | |
| Treated bipolar disorder† | 320 | 4 (1.3) | 1.17 (0.44 to 3.13) | 0.88 (0.33 to 2.34) | |
| Neonatal hypoglycaemia: | |||||
| No bipolar disorder | 331 263 | 8302 (2.5) | 1 (reference) | 1 (reference) | 0.19 |
| Untreated bipolar disorder | 554 | 24 (4.3) | 1.76 (1.15 to 2.68) | 1.51 (1.04 to 2.43) | |
| Treated bipolar disorder† | 320 | 11 (3.4) | 1.38 (0.75 to 2.52) | 1.18 (0.64 to 2.16) | |
*Adjusted for birth order and for maternal age, cohabitation, smoking, height, and diagnosis of alcohol or substance misuse disorder.
†Filling a prescription for lithium, antipsychotics, carbamazepine, lamotrigine, or valproate during pregnancy.
‡Includes caesarean delivery, forceps, and ventouse.
§Adjusted for caesarean delivery, preterm birth, and remaining covariates in table.