Lithium exposure during pregnancy increases fetal growth

Eline Poels*, Karin Sterrenburg, André Wierdsma, Richard Wesseloo, Annemerle Beerthuizen, L van Dijke, C Lau, Witte Hoogendijk, Hanan El Marroun, I van Kamp, Hilmar Bijma, Veerle Bergink

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

9 Citations (Scopus)
10 Downloads (Pure)


Background: Lithium is an effective treatment in pregnancy and postpartum for the prevention of relapse in bipolar disorder, but there is a lack of knowledge about the potential adverse impact on fetal development. Aims: To investigate the impact of lithium exposure on early fetal growth. Methods: In this retrospective observational cohort study, we included all singleton pregnancies of women using lithium and referred for advanced fetal ultrasound scanning between 1994 and 2018 to the University Medical Centers in Leiden and Rotterdam, the Netherlands (n=119). The Generation R study, a population-based cohort, served as a non-exposed control population from the same geographic region (n=8184). Fetal head circumference, abdominal circumference, femur length, and transcerebellar diameter were measured by ultrasound at 18–22 weeks of gestation. Results: Lithium use during pregnancy was associated with an average increase in head circumference of 1.77 mm (95% confidence interval: 0.53, 3.01), in abdominal circumference of 5.54 mm (95% confidence interval: 3.95, 7.12) and in femur length of 0.59 mm (95% confidence interval: 0.22, 0.96) at 18–22 weeks gestation. Furthermore, lithium use during pregnancy was associated with an average increase in birth weight of 142.43 grams (95% confidence interval: 58.01, 226.89), whereas it was associated with an average decrease of 1.41 weeks in gestational duration (95% confidence interval: −1.78, −1.05). Conclusions: Lithium use during pregnancy was associated with increased fetal growth parameters at 18–22 weeks gestational age and increased birth weight. Further research is needed to evaluate both short- and long-term implications, as well as the mechanisms driving this difference in growth.

Original languageEnglish
Pages (from-to)178-183
Number of pages6
JournalJournal of Psychopharmacology
Issue number2
Early online date20 Jul 2020
Publication statusPublished - 2021

Bibliographical note

Publisher Copyright:
© The Author(s) 2020.


Dive into the research topics of 'Lithium exposure during pregnancy increases fetal growth'. Together they form a unique fingerprint.

Cite this