dc.contributor.author | Westin, Andreas | |
dc.contributor.author | Brekke, Malin | |
dc.contributor.author | Molden, Espen | |
dc.contributor.author | Skogvoll, Eirik | |
dc.contributor.author | Aadal, Marianne | |
dc.contributor.author | Spigset, Olav | |
dc.date.accessioned | 2018-01-29T13:38:44Z | |
dc.date.available | 2018-01-29T13:38:44Z | |
dc.date.created | 2017-06-14T11:12:44Z | |
dc.date.issued | 2017 | |
dc.identifier.issn | 2044-6055 | |
dc.identifier.uri | http://hdl.handle.net/11250/2480321 | |
dc.description.abstract | Objectives Pregnancy may cause changes in drug disposition, dose requirements and clinical response. For lithium, changes in disposition during pregnancy have so far been explored in a single-dose study on 4 participants only. The aim of this study was to determine the effect of pregnancy on serum levels of lithium in a larger patient material in a naturalistic setting.
Design A retrospective observational study of patient data from 2 routine therapeutic drug monitoring services in Norway, linked to the Medical Birth Registry of Norway.
Setting Norway, October 1999 to December 2011.
Measurements Dose-adjusted drug concentrations of lithium during pregnancy were compared with the women's own baseline (non-pregnant) values, using a linear mixed model.
Results Overall, coupling 196 726 serum concentration measurements from 54 393 women to the national birth registry identified 25 serum lithium concentration analyses obtained from a total of 14 pregnancies in 13 women, and 63 baseline analyses from the same women. Dose-adjusted serum concentrations in the third trimester were significantly lower than baseline (−34%; CI −44% to −23%, p<0.001).
Conclusions Pregnancy causes a clinically relevant decline in maternal lithium serum concentrations. In order to maintain stable lithium concentrations during the third trimester of pregnancy, doses generally need to be increased by 50%. Individual variability in decline implies that lithium levels should be even more closely monitored throughout pregnancy and in the puerperium than in non-pregnant women to ensure adequate dosing. | nb_NO |
dc.language.iso | eng | nb_NO |
dc.publisher | BMJ Publishing Group | nb_NO |
dc.rights | Navngivelse-Ikkekommersiell 4.0 Internasjonal | * |
dc.rights.uri | http://creativecommons.org/licenses/by-nc/4.0/deed.no | * |
dc.title | Changes in drug disposition of lithium during pregnancy: A retrospective observational study of patient data from two routine therapeutic drug monitoring services in Norway | nb_NO |
dc.type | Journal article | nb_NO |
dc.type | Peer reviewed | nb_NO |
dc.description.version | publishedVersion | nb_NO |
dc.source.volume | 7 | nb_NO |
dc.source.journal | BMJ Open | nb_NO |
dc.source.issue | 3 | nb_NO |
dc.identifier.doi | 10.1136/bmjopen-2016-015738 | |
dc.identifier.cristin | 1475976 | |
dc.description.localcode | © 2017 The Authors. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license | nb_NO |
cristin.unitcode | 194,65,25,0 | |
cristin.unitcode | 194,65,15,0 | |
cristin.unitname | Institutt for sirkulasjon og bildediagnostikk | |
cristin.unitname | Institutt for klinisk og molekylær medisin | |
cristin.ispublished | true | |
cristin.fulltext | original | |
cristin.qualitycode | 1 | |