Fornaro M, Maritan E, Ferranti R, et al. - The evidence related to the efficacy and safety of lithium treatment during the peripartum period were examined particularly focusing on women with bipolar disorder and their offspring. Via conducting a systematic review, researchers identified 29 studies for inclusion in the analyses (20 studies were of good quality, and six were of poor quality; one study had an unclear risk of bias, and two had a high risk of bias). The analysis revealed a low risk associated with lithium exposure at any time during pregnancy, and the risk is higher for first-trimester or higher-dosage exposure. They observed higher odds of any congenital anomaly and of cardiac anomalies in correlation to lithium prescribed during pregnancy. Higher odds of spontaneous abortion during the first trimester were observed in correlation with lithium exposure. They recommend planning pregnancy during remission from bipolar disorder and prescribing lithium within the lowest therapeutic range during pregnancy, especially during the first trimester and the days immediately preceding delivery, balancing the safety and efficacy profile for the individual patient.