Bipolar Disorder (BD) is a chronic psychiatric condition with somatic morbidity that requires continuous mood stabilizing treatment to prevent relapses. Pregnant women with BD have shown an increased rate of caesarean section (C-Section) in comparison with women without BD. Because specific differentiated profiles between mothers with BD that require C-Section and those that do not require C-Section have not been largely discussed, we aim to explore the risk factors associated with the type of delivery in pregnant women with BD. A prospective cohort study was conducted at the Perinatal Mental Health Unit. 100 pregnant women with BD were followed throughout their pregnancy by obstetric and psychiatric services at the same hospital. The cohort was developed in order to compare psychiatric and obstetric outcomes between women with BD that required C-Section (N = 40) versus women that did not require C-Section (N = 60). Final regression models showed an increased risk for obstetric complications during labour (OR 4,52, 95% CI 1,66-12,29), higher rates of hypothyroidism (OR 3,73, 95% CI 1,04-13,73) and treatment with lithium + antidepressant (OR 4,24, 95% CI 1,34-13,40) amongst the C-Section group when compared to the non-C-Section group. In our sample, women with BD treated with lithium plus antidepressant, with hypothyroidism and without obstetric complications have a 70,5% probability of C-Section. In conclusion, psychopharmacology and thyroid function might help understanding which women with BD will have more probability of C-Section. The implementation of more targeted interventions in selected patients might be useful to avoid complications during delivery.

中文翻译：

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双相情感障碍产科并发症：精神因素和剖腹产风险

双相情感障碍 (BD) 是一种具有躯体疾病的慢性精神疾病，需要持续的情绪稳定治疗以防止复发。与没有 BD 的孕妇相比，患有 BD 的孕妇剖腹产（剖腹产）的比例增加。由于需要剖腹产的 BD 母亲和不需要剖腹产的 BD 母亲之间的具体差异特征尚未得到广泛讨论，因此我们旨在探讨与 BD 孕妇分娩类型相关的风险因素。在围产期心理健康部门进行了一项前瞻性队列研究。100 名患有 BD 的孕妇在整个怀孕期间都在同一家医院接受了产科和精神科服务。该队列旨在比较需要剖腹产的 BD 女性（N = 40）与不需要剖腹产的女性（N = 60）之间的精神和产科结果。最终回归模型显示分娩期间产科并发症的风险增加 (OR 4,52, 95% CI 1,66-12,29)，甲状腺功能减退的发生率更高 (OR 3,73, 95% CI 1,04-13,73 ) 和锂 + 抗抑郁药治疗 (OR 4,24, 95% CI 1,34-13,40) 在剖腹产组中与非剖腹产组相比。在我们的样本中，接受锂加抗抑郁药治疗、甲状腺功能减退且没有产科并发症的 BD 女性有 70.5% 的剖腹产概率。总之，精神药理学和甲状腺功能可能有助于了解哪些患有 BD 的女性更有可能进行剖腹产。