Prevalence and determinants of attention deficit/hyperactivity disorder (ADHD) medication use during pregnancy: Results from the Quebec Pregnancy/Children Cohort

Lemelin, Maxim; Boukhris, Takoua; Zhao, Jinping; Sheehy, Odile; Bérard, Anick

doi:10.1002/prp2.781

Cited by 6 publications

(5 citation statements)

References 50 publications

(112 reference statements)

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“…The underlying association may contribute to hyperemesis gravidarum, which is in turn connected with complications such as renal disease, anemia, and cardiac disease in pregnancy, as well as substantially higher rates of neurodevelopmental disorders like ADHD in the fetus ( 32 , 40 ). TORCH infections, post-partum depression, and depressive episodes all relate to well-known sequelae of ADHD; patients with ADHD are more likely to engage in potentially risky behaviors, including unprotected sex, and are at significantly higher risk of developing depression than patients without ADHD ( 29 , 30 ).…”

Section: Discussionmentioning

confidence: 99%

“…There are many studies that investigate risk factors for children developing ADHD (maternal smoking, drug use, depression, parenting style), but even these studies rarely track the ADHD history of parents and do not consider the effect of ADHD on parental health ( 28 ). With an increased population of patients with ADHD in the recent decades and an increase in ADHD medication use during pregnancy it is important to consider what unique risks mothers with ADHD face during the perinatal period ( 29 , 30 ).…”

Section: Introductionmentioning

confidence: 99%

“…The highest prevalence of ADHD medication use is often in the 3 months preceding conception and drops during the first trimester of pregnancy ( 29 ). During pregnancy, women that tend to be prescribed ADHD medication more often have other psychiatric disorders, mood and anxiety disorders ( 30 ). They are also more likely to be older, non-hispanic white, more highly educated, alcohol users during early pregnancy, nulliparous, and less likely to plan their pregnancies ( 29 ).…”

Section: Introductionmentioning

confidence: 99%

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Obstetric complications in mothers with ADHD

Walsh

Rosenberg²,

Hale³

2022

Front. Reprod. Health

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BackgroundThere is currently limited research on the intersection of pregnancy and ADHD and the unique pregnancy risk factors for mothers with an ADHD diagnosis. With an increased population of patients with ADHD in the recent decades and an increase in ADHD medication use during pregnancy it is important to consider what unique risks mothers with ADHD face during the perinatal period.ObjectiveInvestigate a variety of outcomes in maternal ADHD.MethodsWe identified female patients with a diagnosis of pregnancy and ADHD diagnosis. We also further separated the ADHD cohort for separate sub-analyses based on medication type. Odds ratios and relative risk were calculated from outcome incidence within each cohort. Cohorts were balanced on age, sex, and race.ResultsWe identified 45,737 pregnant females with ADHD. We matched these patients to pregnant females without ADHD, for a total of 42,916 pairs. Compared to the group without ADHD, mothers with ADHD had higher rates of every outcome except for HPV infection, which was statistically insignificant (P = 0.768). The odds ratios ranged from 1.08 for anemia complicating pregnancy to 2.63 for depressive episodes. Most outcomes were between 1.2 and 1.8 times more likely to occur in the cohort with ADHD.ConclusionThis study presents substantial advancements in our knowledge of pregnancy-related ADHD care. Armed with an increased awareness of these potential complications and their relationship with ADHD, obstetricians, psychiatrists, and providers of all specialties may be able to reduce the rate of complications within this specific patient population.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Obstetric complications in mothers with ADHD

Walsh

Rosenberg²,

Hale³

2022

Front. Reprod. Health

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“…A Canadian study exploring prevalence and trends of ADHD medication use before and during pregnancy (N = 1130), found higher medication use before pregnancy compared to during pregnancy, and a trimester-specific reduction in medication use from 0.26 to 0.14 per 100 pregnancies from the first to later trimesters. 28 A clinical study from the U.S. characterized the course of ADHD during pregnancy among women aged 18-45 years. They were observed to have discontinued (n = 5), adjusted (n = 8), or maintained their medication through pregnancy (n = 12).…”

Section: Resultsmentioning

confidence: 99%

“…There is limited research on patterns of ADHD medication use in pregnancy. A Canadian study exploring prevalence and trends of ADHD medication use before and during pregnancy ( N = 1130), found higher medication use before pregnancy compared to during pregnancy, and a trimester‐specific reduction in medication use from 0.26 to 0.14 per 100 pregnancies from the first to later trimesters 28 . A clinical study from the U.S. characterized the course of ADHD during pregnancy among women aged 18–45 years.…”

Section: Discussionmentioning

confidence: 99%

Trajectories of ADHD medication use before, during, and after pregnancy: A population‐based study from Norway and Sweden

Srinivas

Karlstad

Stigum

et al. 2023

Pharmacoepidemiology and Drug

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PurposeTo describe ADHD medication use trajectories around pregnancy in Norway and Sweden.MethodsWe identified pregnancies resulting in births using linked data from birth and prescribed drug registers of Norway (2006–2019, N = 813 107) and Sweden (2007–2018, N = 1 269 146). We restricted to women who filled prescriptions for ADHD medication during pregnancy or in the year before or after. We described exposure as use versus no use, and total amount of drug dispensed in defined daily doses (DDDs). Group‐based trajectory modeling was used to identify distinct medication use trajectories.ResultsIn total, 13 286 women (0.64%) filled a prescription for ADHD medication. We identified four trajectory groups: continuers (5.7%), interrupters (23.8%), discontinuers (49.5%), and late initiators (21.0%). Discontinuers were younger, continuers were older on average. More women continued medication in recent years (2014–2019). Most discontinuers (60.7%) were nulliparous; more initiators and continuers had one or multiple previous births, respectively. Continuers were least likely to live with a partner (65.8%). Discontinuers were least likely (24.7%) and continuers most likely (37.6%) to smoke at the beginning of pregnancy. More continuers used amphetamine derivatives and were most likely to use other psychotropics. On modeling continuers, we identified three dose‐trajectory groups which suggested that most women reduced medication dose during pregnancy.ConclusionsMost pregnant women discontinued or interrupted their ADHD medication during pregnancy, but more continued in recent years. Continuers were more likely to have had previous births, less likely to have lived with a partner, and may have had additional comorbidities warranting the use of other psychotropics.

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Impact of COVID-19 pandemic on prescription stimulant use among children and youth: a population-based study

Antoniou,

Pajer,

Gardner

et al. 2024

Eur Child Adolesc Psychiatry

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COVID-19 associated public health measures and school closures exacerbated symptoms in some children and youth with attention-deficit hyperactivity disorder (ADHD). Less well understood is how the pandemic influenced patterns of prescription stimulant use. We conducted a population-based study of stimulant dispensing to children and youth ≤ 24 years old between January 1, 2013, and June 30, 2022. We used structural break analyses to identify the pandemic month(s) when changes in the dispensing of stimulants occurred. We used interrupted time series models to quantify changes in dispensing following the structural break and compare observed and expected stimulant use. Our main outcome was the change in the monthly rate of stimulant use per 100,000 children and youth. Following an initial immediate decline of 60.1 individuals per 100,000 (95% confidence interval [CI] − 99.0 to − 21.2), the monthly rate of stimulant dispensing increased by 11.8 individuals per 100,000 (95% CI 10.0–13.6), with the greatest increases in trend observed among females, individuals in the highest income neighbourhoods, and those aged 20 to 24. Observed rates were between 3.9% (95% CI 1.7–6.2%) and 36.9% (95% CI 34.3–39.5%) higher than predicted among females from June 2020 onward and between 7.1% (95% CI 4.2–10.0%) and 50.7% (95% CI 47.0–54.4%) higher than expected among individuals aged 20–24 from May 2020 onward. Additional research is needed to ascertain the appropriateness of stimulant use and to develop strategies supporting children and youth with ADHD during future periods of long-term stressors.

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Prevalence and determinants of attention deficit/hyperactivity disorder (ADHD) medication use during pregnancy: Results from the Quebec Pregnancy/Children Cohort

Abstract: This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Cited by 6 publications

References 50 publications

Obstetric complications in mothers with ADHD

Obstetric complications in mothers with ADHD

Trajectories of ADHD medication use before, during, and after pregnancy: A population‐based study from Norway and Sweden

Impact of COVID-19 pandemic on prescription stimulant use among children and youth: a population-based study

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