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Lithium has been associated with increased rates of cardiovascular anomalies, primarily Ebstein's anomaly. Researchers in Israel conducted a prospective, observational study to examine associations between lithium and adverse pregnancy outcomes among women seeking advice from a teratology information service. The study population was 183 lithium-exposed pregnancies (90% with first-trimester exposure), 72 lithium-nonexposed pregnancies of women with bipolar disorder, and 748 pregnancies without teratogen exposure.
Rates of miscarriage, elective termination, and preterm delivery were higher in the lithium-exposed group than in the nonteratogen group. The three groups had similar overall rates of major malformations. Cardiovascular malformation…