As the diagnosis of adult attention-deficit/hyperactivity disorder (ADHD) continues to rise, so does the use of its pharmacotherapies, with stimulants most commonly prescribed (amphetamine/dextroamphetamine > methylphenidate). It is currently unknown if stimulant use for ADHD during pregnancy increases the risk of neurodevelopmental disorders in offspring; a recent study set out to investigate this association. Healthcare utilization data from publicly (Medicaid) and commercially (MartketScan) insured pregnancies in the United States was used in the study (N = 4,278,460). Pregnant individuals aged 12 to 55 years with live-births linked to children were required to have insurance coverage from 3 months before the date of the estimated last menstrual period to a minimum of 1 month after delivery. The offspring were monitored for up to 18 years.
The exposed group included pregnant individuals who filled prescriptions for a stimulant during the second half of pregnancy (~week 19 of gestation to birth). Neurodevelopmental disorder (NDD) was a composite of autism spectrum disorders (ASD), ADHD, specific learning disorders, developmental speech or language disorder, developmental coordination disorder, intellectual disability, and behavioral disorder. After controlling for potential confounders, particularly maternal ADHD diagnosis, neither amphetamine/dextroamphetamine exposure nor methylphenidate exposure was associated with NDD, ASD, or ADHD.
Overall, the present results do not suggest an increased risk of NDDs in offspring who were exposed to stimulants in utero. These results also support the role of confounding by indication reported by other studies.
Reference:
Suarez EA et al. JAMA Psychiatry; Epub ahead of print. Abstract
