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  1. Article ; Online: A case of pregnancy with severe polyhydramnios related to long-term use of lithium.

    Stoppa, Aldo / Roda, Ester / Garcia-Esteve, Lluïsa / Roca-Lecumberri, Alba

    Bipolar disorders

    2024  

    Abstract: Objectives: Severe polyhydramnios during pregnancy may be associated with long-term lithium use and presents considerable challenges. This complication, which has been linked to induced nephrogenic diabetes insipidus (NDI), underscores the necessity for ...

    Abstract Objectives: Severe polyhydramnios during pregnancy may be associated with long-term lithium use and presents considerable challenges. This complication, which has been linked to induced nephrogenic diabetes insipidus (NDI), underscores the necessity for cautious management of pregnant women with bipolar disorder. This case report aims to elucidate the relationship between long-term lithium use, pregnancy, and the development of severe polyhydramnios, emphasizing the importance of diagnosing NDI in order to prevent obstetric and neonatal complications.
    Methods: We present the case of a 42-year-old primigravida undergoing long-term lithium treatment for bipolar disorder type I, who developed severe polyhydramnios at 34 weeks of gestation. Clinical data including obstetric monitoring and neonatal outcomes were analyzed.
    Results: This case emphasizes the need for heightened awareness and proactive measures to mitigate the risk associated with lithium treatment during pregnancy. Close monitoring and timely interventions are essential to ensure optimal outcomes for both mother and fetus.
    Conclusions: Our article puts forth the hypothesis that there is a link between lithium use during pregnancy and the occurrence of polyhydramnios and Nephrogenic Diabetes Insipidus (NDI), which may lead to severe obstetric and neonatal complications. This case report contributes to the limited literature on the subject and gives doctors practical advice that may help them make a better risk-benefit analysis. Further research is warranted in order to refine risk assessment protocols and management strategies in this complex clinical scenario.
    Language English
    Publishing date 2024-03-26
    Publishing country Denmark
    Document type Journal Article
    ZDB-ID 1472242-2
    ISSN 1399-5618 ; 1398-5647
    ISSN (online) 1399-5618
    ISSN 1398-5647
    DOI 10.1111/bdi.13427
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    Zs.A 5604: Show issues Location:
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  2. Article ; Online: Treating postpartum affective and/or anxiety disorders in a mother-baby day hospital: preliminary results.

    Roca-Lecumberri, Alba / Torres, Anna / Andrés, Susana / López, Cristina / Naranjo, Carmen / Roda, Ester / Garcia-Esteve, Lluïsa / Gelabert, Estel

    International journal of psychiatry in clinical practice

    2023  Volume 27, Issue 4, Page(s) 344–350

    Abstract: Introduction: Women experiencing perinatal mental-health illness have unique needs. The present study analyzes preliminary data about the effectiveness of MBDH in treating postpartum women with affective and anxiety disorders.: Methods: We analysed ... ...

    Abstract Introduction: Women experiencing perinatal mental-health illness have unique needs. The present study analyzes preliminary data about the effectiveness of MBDH in treating postpartum women with affective and anxiety disorders.
    Methods: We analysed 33 mothers with affective and/or anxiety disorders treated at the MBDH with their babies between March 2018 and December 2019. All women were assessed at admission, discharge and three months after discharge. Outcomes included symptoms of depression (EPDS) and anxiety (STAI-S), mother-infant bonding (PBQ) and functional impairment (HoNOs). We also assessed the clinical significance of changes in patients' scores on these scales and patient satisfaction.
    Results: At discharge, no patients still met the full criteria for the main diagnosis. Between admission and discharge, symptoms of depression and anxiety, mother-infant bonding, functional impairment and autonomy in caring for babies improved significantly. These gains were maintained at three months follow-up. Patient satisfaction was high.
    Conclusions: These preliminary results suggest that multidisciplinary intervention for postpartum women with affective or anxiety disorders at the MBDH improves maternal psychopathology, mother-infant bonding and mothers' ability to care for their babies. MBDHs are a promising approach for delivering specialised perinatal mental-health care for mother-baby dyads.
    MeSH term(s) Pregnancy ; Infant ; Female ; Humans ; Mothers/psychology ; Mother-Child Relations/psychology ; Postpartum Period ; Anxiety Disorders/diagnosis ; Anxiety/psychology ; Hospitals
    Language English
    Publishing date 2023-08-02
    Publishing country England
    Document type Journal Article
    ZDB-ID 1465531-7
    ISSN 1471-1788 ; 1365-1501
    ISSN (online) 1471-1788
    ISSN 1365-1501
    DOI 10.1080/13651501.2023.2236169
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  3. Article ; Online: Obstetric outcomes regarding the use of lithium in pregnant women with bipolar disorders: a prospective cohort study.

    Sagué-Vilavella, Maria / Solé, Eva / Pinzón-Espinosa, Justo / Sandra-Hernández, Ana / Roda, Ester / Vieta, Eduard / Roca, Alba

    Archives of women's mental health

    2022  Volume 25, Issue 4, Page(s) 729–737

    Abstract: Lithium is the mood stabilizer of choice for the prevention of bipolar relapse over the perinatal period. A critical issue is its safety of the mother and the developing fetus. This study aims to compare obstetric outcomes in women with bipolar disorders ...

    Abstract Lithium is the mood stabilizer of choice for the prevention of bipolar relapse over the perinatal period. A critical issue is its safety of the mother and the developing fetus. This study aims to compare obstetric outcomes in women with bipolar disorders (BD) regarding treatment with lithium during pregnancy. We enrolled a cohort of pregnant women with BD that received care at the Perinatal Mental Health Unit of a tertiary hospital between January 2005 and March 2017. The exposed group received lithium during pregnancy, whereas the unexposed group did not. The main outcomes were obstetric complications during pregnancy, during labor and delivery, neonatal complications, and congenital malformations. Demographic and clinical data were described using measures of frequency, central tendency, and dispersion. Between-group differences were calculated with chi-square, Fisher's test, t-tests, or Mann-Whitney U test. Our cohort included 100 pregnant women with BD: 53 (53%) used lithium during pregnancy, and 47 (47%) did not. There were no significant differences in obstetric complications, neonatal complications, or congenital anomalies. Nonetheless, newborns of lithium-treated women had lower Apgar scores at 1 min (mean 8.2 ± 1.6 vs. 8.9 ± 0.6, p = 0.026) and 5 min (9.6 ± 0.8 vs. 9.9 ± 0.5, p = 0.015). Our findings do not identify worse obstetric outcomes in women with BD that take lithium during pregnancy, except for an impact on newborn Apgar scores. Lithium might be an adequate treatment for pregnant women with BD, especially for those with a high recurrence risk, and always after an individualized risk-benefit assessment.
    MeSH term(s) Bipolar Disorder/drug therapy ; Bipolar Disorder/psychology ; Cohort Studies ; Female ; Humans ; Infant, Newborn ; Lithium/therapeutic use ; Parturition ; Pregnancy ; Pregnancy Complications/drug therapy ; Pregnancy Complications/psychology ; Pregnancy Outcome/epidemiology ; Pregnant Women ; Prospective Studies
    Chemical Substances Lithium (9FN79X2M3F)
    Language English
    Publishing date 2022-05-06
    Publishing country Austria
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1463529-X
    ISSN 1435-1102 ; 1434-1816
    ISSN (online) 1435-1102
    ISSN 1434-1816
    DOI 10.1007/s00737-022-01234-8
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    Zs.A 5115: Show issues Location:
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  4. Article ; Online: Obstetric complications in bipolar disorder: The role of mental health disorders in the risk of caesarean section.

    Solé, Eva / Torres, Anna / Roca, Alba / Hernández, Ana Sandra / Roda, Ester / Sureda, Bàrbara / Martin-Santos, Rocío / Vieta, Eduard / Garcia-Esteve, Lluïsa

    Journal of affective disorders

    2019  Volume 252, Page(s) 458–463

    Abstract: Background: Women with Bipolar Disorder (BD) during pregnancy present a negative impact on them and their babies' health. Caesarean Section (C-Section) is an intervention to reduce complications associated with childbirth, but it also has risks, ... ...

    Abstract Background: Women with Bipolar Disorder (BD) during pregnancy present a negative impact on them and their babies' health. Caesarean Section (C-Section) is an intervention to reduce complications associated with childbirth, but it also has risks, including maternal infections, anaesthetic and psychological complications. There are few studies that analyse the C-Section rates in women with BD compared to the general population.
    Methods: A case-control study was conducted in a general university hospital. 100 pregnant women with BD matched with 100 controls without psychiatric illness who were attending the same hospital at delivery. We compared obstetrical outcomes during pregnancy, Pre/During Labour, onset of labour and mode of delivery specifying the type of C-Section.
    Results: Rate of C-Section was significantly higher in BD group compared to the control group (OR=2, 95% CI 1,4-1,6). Case group had more somatic illness (SI) without treatment (P<, 001). BD (P=,021), primiparity (P=, 003), obstetric complications during pregnancy (P<, 001), obstetric complications during labour (P<,001), and SI with and without treatment (P<,001 and P=,007, respectively) were higher in women that required C- section.
    Conclusion: Women with Bipolar Disorder have near two-fold increased risk of C-section than women without Bipolar Disorder of similar age, gestational age and parity. Somatic illness was more prevalent in BD group that required C-section and this relation probably is related to high probability of having somatic comorbidities in patients with BD.
    MeSH term(s) Adult ; Bipolar Disorder/complications ; Case-Control Studies ; Cesarean Section/psychology ; Cesarean Section/statistics & numerical data ; Female ; Gestational Age ; Humans ; Parity ; Pregnancy ; Pregnancy Complications/psychology ; Pregnancy Complications/surgery ; Risk Factors ; Young Adult
    Language English
    Publishing date 2019-04-08
    Publishing country Netherlands
    Document type Evaluation Study ; Journal Article
    ZDB-ID 135449-8
    ISSN 1573-2517 ; 0165-0327
    ISSN (online) 1573-2517
    ISSN 0165-0327
    DOI 10.1016/j.jad.2019.04.017
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    Zs.A 1485: Show issues Location:
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  5. Article ; Online: The CYP17 MspA1 Polymorphism and the Gender Dysphoria.

    Fernández, Rosa / Cortés-Cortés, Joselyn / Esteva, Isabel / Gómez-Gil, Esther / Almaraz, Mari Cruz / Lema, Estefanía / Rumbo, Teresa / Haro-Mora, Juan-Jesús / Roda, Ester / Guillamón, Antonio / Pásaro, Eduardo

    The journal of sexual medicine

    2015  Volume 12, Issue 6, Page(s) 1329–1333

    Abstract: Introduction: The A2 allele of the CYP17 MspA1 polymorphism has been linked to higher levels of serum testosterone, progesterone, and estradiol.: Aim: To determine whether the CYP17 MspA1 polymorphism is associated with transsexualism.: Methods: ... ...

    Abstract Introduction: The A2 allele of the CYP17 MspA1 polymorphism has been linked to higher levels of serum testosterone, progesterone, and estradiol.
    Aim: To determine whether the CYP17 MspA1 polymorphism is associated with transsexualism.
    Methods: We analyzed 151 male-to-female (MtF), 142 female-to-male (FtM), 167 control male, and 168 control female individuals. Fragments that included the mutation were amplified by PCR and digested with MspA1. Our data were compared with the allele/genotype frequencies provided by the 1000 Genomes Data Base, and contrasted with a MEDLINE search of the CYP17 MspA1 polymorphism in the literature.
    Main outcome measures: We investigated the association between transsexualism and the CYP17 MspA1 polymorphism.
    Results: A2 frequency was higher in the FtM (0.45) than the female control (0.38) and male control (0.39) groups, or the MtF group (0.36). This FtM > MtF pattern reached statistical significance (P = 0.041), although allele frequencies were not gender specific in the general population (P = 0.887). This observation concurred with the 1000 Genomes Data Base and the MEDLINE search.
    Conclusion: Our data confirm a sex-dependent allele distribution of the CYP17 MspA1 polymorphism in the transsexual population, FtM > MtF, suggestive of a hypothetical A2 involvement in transsexualism since the allele frequencies in the general population seem to be clearly related to geographic origin and ethnic background, but not sex.
    MeSH term(s) Alleles ; Female ; Gene Frequency ; Genotype ; Hispanic Americans/psychology ; Humans ; Male ; Middle Aged ; Polymerase Chain Reaction ; Polymorphism, Genetic/genetics ; Steroid 17-alpha-Hydroxylase/genetics ; Transsexualism/genetics ; Transsexualism/psychology
    Chemical Substances Steroid 17-alpha-Hydroxylase (EC 1.14.14.19)
    Language English
    Publishing date 2015-06
    Publishing country Netherlands
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2251959-2
    ISSN 1743-6109 ; 1743-6095
    ISSN (online) 1743-6109
    ISSN 1743-6095
    DOI 10.1111/jsm.12895
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  6. Article ; Online: The (CA)n polymorphism of ERβ gene is associated with FtM transsexualism.

    Fernández, Rosa / Esteva, Isabel / Gómez-Gil, Esther / Rumbo, Teresa / Almaraz, Mari Cruz / Roda, Ester / Haro-Mora, Juan-Jesús / Guillamón, Antonio / Pásaro, Eduardo

    The journal of sexual medicine

    2014  Volume 11, Issue 3, Page(s) 720–728

    Abstract: Introduction: Transsexualism is a gender identity disorder with a multifactorial etiology. Neurodevelopmental processes and genetic factors seem to be implicated.: Aim: The aim of this study was to investigate the possible influence of the sex ... ...

    Abstract Introduction: Transsexualism is a gender identity disorder with a multifactorial etiology. Neurodevelopmental processes and genetic factors seem to be implicated.
    Aim: The aim of this study was to investigate the possible influence of the sex hormone-related genes ERβ (estrogen receptor β), AR (androgen receptor), and CYP19A1 (aromatase) in the etiology of female-to-male (FtM) transsexualism.
    Methods: In 273 FtMs and 371 control females, we carried out a molecular analysis of three variable regions: the CA repeats in intron 5 of ERβ; the CAG repeats in exon 1 of AR, and the TTTA repeats in intron 4 of CYP19A1.
    Main outcome measures: We investigated the possible influence of genotype on transsexualism by performing a molecular analysis of the variable regions of genes ERβ, AR, and CYP19A1 in 644 individuals (FtMs and control females).
    Results: FtMs differed significantly from control group with respect to the median repeat length polymorphism ERβ (P = 0.002) but not with respect to the length of the other two studied polymorphisms. The repeat numbers in ERβ were significantly higher in FtMs than in control group, and the likelihood of developing transsexualism was higher (odds ratio: 2.001 [1.15-3.46]) in the subjects with the genotype homozygous for long alleles.
    Conclusions: There is an association between the ERβ gene and FtM transsexualism. Our data support the finding that ERβ function is directly proportional to the size of the analyzed polymorphism, so a greater number of repeats implies greater transcription activation, possibly by increasing the function of the complex hormone ERβ receptor and thereby encouraging less feminization or a defeminization of the female brain and behavior.
    MeSH term(s) Adult ; Alleles ; Aromatase/genetics ; Case-Control Studies ; Estrogen Receptor beta/genetics ; Female ; Genotype ; Humans ; Polymorphism, Genetic/genetics ; Receptors, Androgen/genetics ; Transsexualism/genetics
    Chemical Substances AR protein, human ; Estrogen Receptor beta ; Receptors, Androgen ; Aromatase (EC 1.14.14.1) ; CYP19A1 protein, human (EC 1.14.14.1)
    Language English
    Publishing date 2014-03
    Publishing country Netherlands
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2251959-2
    ISSN 1743-6109 ; 1743-6095
    ISSN (online) 1743-6109
    ISSN 1743-6095
    DOI 10.1111/jsm.12398
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  7. Article ; Online: Association study of ERβ, AR, and CYP19A1 genes and MtF transsexualism.

    Fernández, Rosa / Esteva, Isabel / Gómez-Gil, Esther / Rumbo, Teresa / Almaraz, Mari Cruz / Roda, Ester / Haro-Mora, Juan-Jesús / Guillamón, Antonio / Pásaro, Eduardo

    The journal of sexual medicine

    2014  Volume 11, Issue 12, Page(s) 2986–2994

    Abstract: Introduction: The etiology of male-to-female (MtF) transsexualism is unknown. Both genetic and neurological factors may play an important role.: Aim: To investigate the possible influence of the genetic factor on the etiology of MtF transsexualism.!## ...

    Abstract Introduction: The etiology of male-to-female (MtF) transsexualism is unknown. Both genetic and neurological factors may play an important role.
    Aim: To investigate the possible influence of the genetic factor on the etiology of MtF transsexualism.
    Methods: We carried out a cytogenetic and molecular analysis in 442 MtFs and 473 healthy, age- and geographical origin-matched XY control males. The karyotype was investigated by G-banding and by high-density array in the transsexual group. The molecular analysis involved three tandem variable regions of genes estrogen receptor β (ERβ) (CA tandem repeats in intron 5), androgen receptor (AR) (CAG tandem repeats in exon 1), and CYP19A1 (TTTA tandem repeats in intron 4). The allele and genotype frequencies, after division into short and long alleles, were obtained.
    Main outcome measures: We investigated the association between genotype and transsexualism by performing a molecular analysis of three variable regions of genes ERβ, AR, and CYP19A1 in 915 individuals (442 MtFs and 473 control males).
    Results: Most MtFs showed an unremarkable 46,XY karyotype (97.96%). No specific chromosome aberration was associated with MtF transsexualism, and prevalence of aneuploidy (2.04%) was slightly higher than in the general population. Molecular analyses showed no significant difference in allelic or genotypic distribution of the genes examined between MtFs and controls. Moreover, molecular findings presented no evidence of an association between the sex hormone-related genes (ERβ, AR, and CYP19A1) and MtF transsexualism.
    Conclusions: The study suggests that the analysis of karyotype provides limited information in these subjects. Variable regions analyzed from ERβ, AR, and CYP19A1 are not associated with MtF transsexualism. Nevertheless, this does not exclude other polymorphic regions not analyzed.
    MeSH term(s) Adult ; Alleles ; Aromatase/genetics ; Aromatase/physiology ; Case-Control Studies ; Chromosome Aberrations ; Estrogen Receptor beta/genetics ; Female ; Genotype ; Gonadal Steroid Hormones/genetics ; Humans ; Karyotyping ; Male ; Receptors, Androgen/genetics ; Tandem Repeat Sequences/genetics ; Transsexualism/genetics
    Chemical Substances AR protein, human ; Estrogen Receptor beta ; Gonadal Steroid Hormones ; Receptors, Androgen ; Aromatase (EC 1.14.14.1) ; CYP19A1 protein, human (EC 1.14.14.1)
    Language English
    Publishing date 2014-12
    Publishing country Netherlands
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2251959-2
    ISSN 1743-6109 ; 1743-6095
    ISSN (online) 1743-6109
    ISSN 1743-6095
    DOI 10.1111/jsm.12673
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