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bluemoon

cardiac abnormality in a child born to a mother who was on Li

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What is the risk of cardiac abnormality in a child born to a mother who was on Li in the 1st trimester of her pregnancy
Choose one answer.
a. 1/100   b. 1/10000   c. 1 in 10   d. 1/1000   e. 1 in 5

 

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In Humans. Numerous studies have noted an association between first trimester administration of lithium carbonate and incidence of cardiovascular malformations such as Ebstein's anomaly in the neonates.[39-41] The International Register of Lithium Babies was started in 1968 to assess this potential teratogenicity of lithium in humans.[42] As of 1980, 225 infants who had been exposed to lithium during the first 3 months of prenatal life or longer were included in the register. Among these, 18 infants had the rare Ebstein's anomaly (6 cases) and other anomalies of the cardiovascular system (12 cases); 7 were stillborn; 2 had Down syndrome; and 1 had intracerebral toxoplasmosis. The data from the register suggest an incidence rate of 0.1% for Ebstein's anomaly, which is approximately 20 times the risk in the general population. Another report of data from 1970 to 1985 details nine cases of Ebstein's anomaly in the United States out of an estimated 9,000 exposures.[39] Therefore, it appears that risk of fetal malformation, especially pertaining to the cardiovascular system, is increased by first trimester lithium administration.[43]

Risk is 0.1% or 1 in 10

Relative risk is 10-20 times

Absolute risk is 1:1000

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SPMM Says; 

 

1:10 chance of having any malformation (including Ebstein Anamoly) if Li continued.

Ebstein Anomaly : Risk is 0.1% or 1 in 10
Relative risk is 10-20 times
Absolute risk is 1:1000 ( 1/1000 x 100 = 0.1% or 1in 10)

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