Intravenous Pentazocine and Methylphenidate Abuse During Pregna

Debooy, V. D.; Seshia, Mary; Tenenbein, Milton; Casiro, Oscar G.

doi:10.1001/archpedi.1993.02160340048012

Cited by 33 publications

(19 citation statements)

References 16 publications

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“…A risk increase of preterm birth, low birth weight and small-for gestational age is seen in infants whose mothers abused amphetamine (review in [138]). Also abuse of methylphenidate resulted in a high rate of preterm birth and growth retardation [139]. …”

Section: Resultsmentioning

confidence: 99%

The Use of Central Nervous System Active Drugs During Pregnancy

2013

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CNS-active drugs are used relatively often during pregnancy. Use during early pregnancy may increase the risk of a congenital malformation; use during the later part of pregnancy may be associated with preterm birth, intrauterine growth disturbances and neonatal morbidity. There is also a possibility that drug exposure can affect brain development with long-term neuropsychological harm as a result. This paper summarizes the literature on such drugs used during pregnancy: opioids, anticonvulsants, drugs used for Parkinson’s disease, neuroleptics, sedatives and hypnotics, antidepressants, psychostimulants, and some other CNS-active drugs. In addition to an overview of the literature, data from the Swedish Medical Birth Register (1996–2011) are presented. The exposure data are either based on midwife interviews towards the end of the first trimester or on linkage with a prescribed drug register. An association between malformations and maternal use of anticonvulsants and notably valproic acid is well known from the literature and also demonstrated in the present study. Some other associations between drug exposure and outcome were found.

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Section: Resultsmentioning

confidence: 99%

The Use of Central Nervous System Active Drugs During Pregnancy

2013

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“…The twins had malformations compatible with foetal alcohol syndrome, and major malformations were recorded in two other infants. This study was confounded by the concurrent abuse of cigarettes, alcohol, other drugs and concurrent diseases, and therefore was excluded [12]. Lastly, four papers were identified from the reference lists.…”

Section: Resultsmentioning

confidence: 99%

First Trimester In Utero Exposure to Methylphenidate

Dideriksen

Pottegård

Hallas

et al. 2013

Basic Clin Pharma Tox

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Methylphenidate is a centrally acting sympathomimetic used for the treatment of attention deficit/hyperactivity disorder in children and adolescents and for narcolepsy in adults. Despite the growing use among adult women, no reliable data on the prevalence of use during pregnancy have been published, and safety during pregnancy has not been established. We systematically reviewed available data on birth outcome after human in utero exposure to methylphenidate. Systematic searches in PubMed/Embase were performed from origin to August 2012, and data from Michigan Medicaid recipients, The Collaborative Perinatal Project and the Swedish Birth Registry were evaluated. Excluding three case reports, a total of 180 children exposed to methylphenidate in utero during first trimester were identified, among whom, four children with major malformations were observed. Methylphenidate exposure during pregnancy does not appear to be associated with a substantially (i.e. more than twofold) increased risk of congenital malformations.

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“…22,23 A cohort study also identified an association between late pregnancy therapeutic methamphetamine use and fetal growth restriction. 24 A recent cohort study compared women who used ADHD medication and women with ADHD diagnosis without medication to women with no ADHD diagnosis or medication in the general population of pregnancies in Denmark from 1997–2008.…”

Section: Discussionmentioning

confidence: 99%

Placental Complications Associated With Psychostimulant Use in Pregnancy

Cohen

Hernández–Dı́az

Bateman

et al. 2017

Obstetrics &Amp; Gynecology

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Objective To evaluate whether psychostimulants used to treat attention-deficit hyperactivity disorder (ADHD) are associated with risk of adverse placental-associated pregnancy outcomes including preeclampsia, placental abruption, growth restriction, and preterm birth. Methods We designed a population-based cohort study where we examined a cohort of pregnant women and their liveborn infants enrolled in Medicaid from 2000 to 2010. Women who received amphetamine–dextroamphetamine or methylphenidate monotherapy in the first half of pregnancy were compared to unexposed women. We considered atomoxetine, a non-stimulant ADHD medication, as a negative control exposure. To assess whether the risk period extended to the latter half of pregnancy, women who continued stimulant monotherapy after 20 weeks were compared to those who discontinued. Risk ratios (RRs) and 95% confidence intervals (CIs) were estimated with propensity score stratification to control for confounders. Results Pregnancies exposed to amphetamine/dextroamphetamine (n=3331), methylphenidate (n=1515), and atomoxetine (n=453) monotherapy in early pregnancy were compared to 1,461,493 unexposed pregnancies. Among unexposed women, the risks of the outcomes were 3.7% for preeclampsia, 1.4% for placental abruption, 2.9% for small for gestational age, and 11.2% for preterm birth. The adjusted RR for stimulant use was 1.29 for preeclampsia (95% CI 1.11–1.49), 1.13 for placental abruption (0.88–1.44), 0.91 for small for gestational age (SGA; 0.77–1.07) and 1.06 for preterm birth (0.97–1.16). Compared to discontinuation (n=3527), the adjusted RR for continuation of stimulant use in the latter half of pregnancy (n=1319) was 1.26 for preeclampsia (0.94–1.67), 1.08 for placental abruption (0.67–1.74), 1.37 for SGA (0.97–1.93), and 1.30 for preterm birth (1.10–1.55). Atomoxetine was not associated with the outcomes studied. Conclusion Psychostimulant use during pregnancy was associated with a small increased relative risk of preeclampsia and preterm birth. The absolute increases in risks are small and thus, women with significant ADHD should not be counseled to suspend their ADHD treatment based on these findings.

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Intravenous Pentazocine and Methylphenidate Abuse During Pregna

Cited by 33 publications

References 16 publications

The Use of Central Nervous System Active Drugs During Pregnancy

The Use of Central Nervous System Active Drugs During Pregnancy

First Trimester In Utero Exposure to Methylphenidate

Placental Complications Associated With Psychostimulant Use in Pregnancy

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