Maternal Bipolar Disorder Significantly Increases Risk for Premature Births

premature
A premature infant lying on a hospital bed just his size. Credit to flickr.com user César Rincon. Used with permission under a Creative Commons license.

Premature babies–infants born before the 37th week of pregnancy–endure a great number of challenges, such as high blood pressure, hypoglycemia, and breathing properly. No one wants their baby to be born early, unless there’s a risk to the mother.

But, unfortunately for mothers with severe bipolar disorder, they may not have a choice. A 2015 study published in the American Journal of Obstetrics and Gynecology showed that mothers with bipolar disorder are twice as likely to give birth prematurely than mothers with no mental illnesses. And a 2010 study published in the Journal of Affective Disorders demonstrated that in Taiwan, the incidence rate of premature births among pregnant women with bipolar disorder was 14.2%, compared to 6.9% of women without mental illnesses. The Taiwan study also included statistics about infants with low birth weights (9.8% vs. 5.7%), and smaller-than-gestational-age babies (22.3% vs. 15.7%).

Unfortunately, premature babies are also 2.7 times more likely than full-term babies to develop bipolar disorder later in life. For a full breakdown of these statistics, including the risk for psychosis and schizophrenia, click here.

But it’s not all bad news. The rates of premature births for bipolar mothers aren’t very high. A 14.2% chance to have a preterm baby means that you have an 85.8% chance to have a full-term baby. That’s pretty good!

So what can you do to prevent preterm births? The risk factors for a premature infant include:

  • Already having had a premature baby. This is a major risk factor.
  • A second pregnancy soon after having a baby.
  • Being pregnant with twins or more.
  • Having uterine or cervix problems.
  • Being overweight or underweight.
  • High blood pressure, stress, diabetes, and some infections.
  • Smoking and substance use.
  • Becoming ill with the flu.

Some of these things you can’t control, like having twins. But others, you can, such as avoiding pregnancy soon after having a baby, stopping substance use, or getting your flu shot. Maintaining a healthy weight during pregnancy also helps, so be sure to exercise and eat a healthy diet.

Final Thoughts

Premature birth can be scary and challenging. But, while the likelihood of giving birth prematurely is increased for bipolar mothers, the overall rate isn’t that high. Follow your obstetrician’s advice. There are some steps you can take in order to hopefully prevent a preterm infant.

Good luck!

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Preemies Have Higher Risk to Develop Bipolar Disorder

Premature infants face a variety of challenges, including gaining weight, hypothermia and hypoglycemia, and possibly respiratory distress syndrome. Yet there’s another challenge for these babies: the risk of developing mental illnesses.

A new study led by Chiara Nosarti, PhD, of the Department of Psychosis Studies in the Institute of Psychiatry at London’s King’s College, demonstrated that babies born preterm have an elevated risk to develop a range of psychiatric conditions later in life, including psychosis, depression, and bipolar disorder, with bipolar being the highest. Past research has shown that preemies may develop schizophrenia as adults, but little had been studied about bipolar disorder and depression.

Bipolar disorder is a mental illness characterized by “highs” (called mania) and “lows” (called depression). These extreme changes in mood are disruptive to the lives of the individuals who suffer from bipolar disorder.

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A premature baby in a hospital bed, with an adult hand nearby. Credit to flickr.com user César Rincón. Used with permission under a Creative Commons license.

The scientists pooled data from the Swedish Medical Birth Register for all people born between 1973 and 1985 who were living in Sweden in December, 2000, which totaled 1,301,522 people. The researchers concentrated on the week in which these individuals were born, and looked at whether they had been hospitalized for mental conditions including psychosis, bipolar disorder, and drug and alcohol dependencies.

Preemies born between 32 and 36 weeks were 2.7 times more likely to develop bipolar disorder. They were 1.3 times more likely to develop depressive disorders, and 1.6 times more likely to have nonaffective psychosis.

Younger babies were showed an even stronger association to develop psychiatric conditions. Preemies born before 32 weeks were 7.4 more likely to develop bipolar disorder, 2.5 times more likely for psychosis, and 2.9 times more likely for depression. The infants born before 23 weeks were also more than three times more likely to develop an eating disorder.

However, the scientists did not look at other factors that could contribute to the development of mental illnesses, such as socioeconomic factors, ethnicity, or substance abuse. Another limitation to the study is that the researchers only considered hospitalizations, so milder cases of psychiatric conditions were missed.

The scientists hope that their work will shine a light on preterm infants’ struggles, and that mental illnesses such as bipolar disorder can be more easily diagnosed.

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Antibodies That Cause Encephalitis Linked to Psychosis

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Credit to flickr user Parthiv Haldipur. Used with permission under a Creative Commons license.

Psychosis, a break from reality, is a common feature of bipolar disorder. People can suffer delusions, hallucinations, depression, anxiety, and incoherent speech. The breaks are especially dangerous for postpartum women, who may harm their infants. The causes of psychosis are varied, ranging from mental illnesses such as schizophrenia or bipolar disorder, to sleep deprivation, substance abuse, or prescription drugs.

But new research has linked psychosis to antibodies that cause encephalitis, a life-threatening disease which inflames the brain. There is hope that removing these antibodies will treat psychosis just as much as doing so treats encephalitis. Some of the antibodies act against a nerve cell protein called NMDAR, or the NMDA receptor.

Belinda R. Lennox, a psychiatry professor at the University of Oxford in the United Kingdom, led a team of researchers who conducted a study on 228 people with first-episode psychosis. The scientists drew blood from the patients within the first six weeks of treatment. They also collected blood from a group of healthy people and used that as the control group for the study.

Seven–three percent–of the patients with first-episode psychosis presented with NMDAR antibodies. None of the controls did. A previous study from 2015 found that children experiencing their first episode of psychosis also had antibodies relating to the NMDAR.

The good news is that, Lennox and her team, using an experimental immunotherapy that targets the antibodies, successfully treated patients with psychosis, and helped them recover function after their episodes.

Three percent may not be much, but it’s three percent more of people who may be able to be treated with immunosuppressant therapies. This is a significant minority, one that shows promise. Lennox and her team plan to conduct a randomized, controlled trial of immune treatment in people with psychosis in 2017.

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