Daily Trends of Mood During Pregnancy for Women With Bipolar Disorder

A pregnant woman and her doctor are indoors in a medical center. The woman is holding her stomach while the doctor writes information on a clipboard.
This particular study seeks to investigate the relationship between pregnancy and the course of Bipolar Disorder.

Daily mood scores did not differ between pregnant and nonpregnant women with bipolar disorder (BD). These findings were published in the International Journal of Bipolar Disorders.

Data for this study were sourced from the LifeChart Method (LCM) which were collected for 2 observational, prospective cohort studies. Daily LCM information from pregnant women (n=34) with BD living in the Netherlands between 2012-2018 were compared with nonpregnant women (n=52) with BD living in the Netherlands between 1995-2000. The women reported their daily BD symptoms over a period of time spanning from week 13 of pregnancy to 12 weeks postpartum.

Pregnant and nonpregnant women were aged mean 34.1 (standard deviation [SD], 3.9) and 35.2 (SD, 6.3) years; 97.1% and 46.2% were married or cohabitating (P <.01); 72.7% and 15.4% had a high education level (P <.01); and 78.8% and 59.2% had regular work, attended school, or took care of a household (P <.01), respectively. The pregnant women took other medications (P <.01) and had fewer depressive episodes (P =.04) at baseline.

Average mania scores were similar among pregnant and nonpregnant women (mean, 0.23 vs 0.39; P =.40) as were depression scores (mean, 0.34 vs 0.45; P =.38). During the study period, no significant differences were observed for number of depressive episodes, manic episodes, hypomanic episodes, manic days, hypomanic days, depressive days, or days ill (all P ³.16).

Stratified by illness severity, there were fewer pregnant women who were severely ill (32% vs 68%; X2, 48.02; P <.001) and the pregnant women had lower levels of entropy each day (mean, 0.43 vs 0.56).

Educational status was significantly associated with severity of illness (odds ratio [OR], 6.71; standard error [SE], 0.67; P <.01) and mood entropy (b, -0.134; SE, 0.054; P =0.16). These associations indicated that individuals with lower education were more likely to have an unstable course of BD and less likely to be moderately ill.

This study may have been limited by its unbalanced cohorts at baseline and the fact that data were not collected concurrently.

Overall, pregnant and nonpregnant women with BD did not differ on a daily basis for mood, and pregnant women were less likely to have severe, unpredictable illness. These discrepancies may be due to the differences in medication taken by the 2 cohorts. Additional studies are needed to clarify these findings.


Stevens AWMM, Draisma S, Goossens PJJ, et al. The course of bipolar disorder in pregnant versus non‑pregnant women. Int J Bipolar Disord. 2021;9(1):35. doi:10.1186/s40345-021-00239-z