Modest Increased Risk For Neonatal Side Effects After Prescribed ADHD Meds During Pregnancy

MedicalResearch.com Interview with:
“1. pregnancy” by TipsTimesAdmin is licensed under CC BY 2.0
Ulrika Nörby MScPharm, PhD
Department of E-health and strategic IT
Stockholm County Council
Sweden

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The use of ADHD medication has increased rapidly during the last 10 years, especially among young women. Thereby, questions regarding treatment with these drugs during pregnancy are common. Until now, data concerning fetal safety of ADHD medication have been sparse, especially when it comes to neonatal disorders. For amphetamine preparations, most previous studies concerned illicit drug use during pregnancy, which made it difficult to draw conclusions. Our objective was to estimate birth and neonatal outcomes after maternal use of prescribed ADHD medication during pregnancy.

The main findings were that infants exposed to ADHD medication in utero had a somewhat increased risk of neonatal morbidity, especially CNS-related disorders. The odds ratio (OR) for a CNS-disorder was 1.9 for exposed infants compared to non-exposed infants. Further, exposed infants more often needed treatment at a neonatal intensive care unit (NICU), OR 1.5, and were more frequently moderately preterm, OR 1.3. The risk for CNS-related disorders and admission to a NICU was increased also compared to infants whose mothers used ADHD before or after, but not during, pregnancy. This finding suggests a causal relationship between treatment with ADHD medication and the neonatal outcomes. Because of large differences in maternal background characteristics between treated and non-treated women, it is however uncertain to what extent the higher neonatal morbidity is caused by the ADHD medication.

MedicalResearch.com: What should readers take away from your report?

Response: There is a modest risk increase for neonatal morbidity, especially CNS-related disorders, after maternal use of ADHD medication during pregnancy. This warrant attention. Based on our study, there is however no need to abstain from treatment during pregnancy, if the ADHD medication is crucial for the pregnant woman. 

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: An even larger sample with infants exposed to ADHD medication would yield clearer answers. There were only 16 exposed infants in our study diagnosed with CNS-related disorders. Thus, we cannot rule out that the increased risk of CNS-symptoms was a random finding. Further, it would be interesting to find out whether there is a difference between the centrally stimulating drugs like methylphenidate and amphetamine and the non-stimulant atomoxetine.   

MedicalResearch.com: Is there anything else you would like to add?

Response: We were a bit astonished that there were such large differences in background characteristics between women who used ADHD medication and not. Treated women were younger, more often singles, smokers, and frequently used other drugs like antidepressants and psychotropics concomitantly. Altogether, this implies that women who use ADHD medication are a vulnerable group with several risk factors for negative fetal impact.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community

Citation:

Pediatrics November 2017
Perinatal Outcomes After Treatment With ADHD Medication During Pregnancy
Ulrika Nörby, Birger Winbladh, Karin Källén

http://pediatrics.aappublications.org/content/early/2017/11/08/peds.2017-0747

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions. 

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