It is important to note that the bipolar women who were
unstable during pregnancy showed the highest rates of
postpartum relapse.
In particular, we observed that prophylaxis
during pregnancy in bipolar women is important
not only to maintain mood stability during pregnancy but
also to prevent episodes postpartum.
However, the benefits
of continuous lithium use for affective stability in the
mother, both during pregnancy and postpartum, must be
carefully weighed against the teratogenic effects of lithium
during early pregnancy and the elevated rate of neonatal
complications (4, 20, 21).
Further, the benefits of postpartum
prophylactic treatment with lithium must be considered
in light of the relative risk to infants of breast-feeding
exposure versus the loss of the benefits of breast-feeding.