We conducted a naturalistic longitudinal study that prospectively assessed adolescents with bipolar disorder after their first manic episode. Each participant's legal guardian was given a complete description of the study, and they provided written informed consent; adolescents also provided written assent. The study was approved by the institutional review boards of the University of Cincinnati and Cincinnati Children's Hospital Medical Center. In our study, 83% (19/23) of the adolescent girls (ages 15-19 years) were sexually active, and 30% (7/23) experienced an unplanned pregnancy at least once during the follow-up period (median weeks in study=105; median weeks to first pregnancy=59) while they were still under the age of 20. Additionally, six of eight pregnancies (one of the seven girls became pregnant twice as a teen) resulted in live births.
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