NEONATAL LITHIUM TOXICITY AS A RESULT OF MATERNAL TOXICITY

Lithium carbonate is used for the treatment of bipolar disorder. Becau se of its widespread use, many women of childbearing age are taking li thium carbonate, which belongs to the US FDA Category D. Administratio n during pregnancy can result in fetal toxicity. A 17-y-old female wit h pre-eclampsia and a history of manic depression gave birth to an inf ant at 37-w gestational age. Several hours prior to delivery, the moth er had a lithium level of 2.6 mEq/L. The infant's initial lithium leve l after birth was 2.1 mEq/L. A subsequent lithium level on the 3rd d o f the child's life was 1.4 mEq/L; the half-life in the infant was >24 h. During the first 4 d of life, the infant was lethargic and exhibite d poor suck-swallow coordination that required supplemental enteral fe eding. By the 7th d of life, the infant was alert and tolerating all o ral feedings. Lithium carbonate readily crosses the placental barrier and can produce teratogenic effects and toxicity. Neonates exposed in utero should be carefully monitored for symptoms of toxicity. In this case only minor toxic effects occurred.