Published on 24/01/2024 in JAMA Psychiatry

Key Points

• A study investigated the association between prescription stimulant treatment for ADHD during pregnancy and the risk of neurodevelopmental disorders in children.
• The study found that exposure to amphetamine/dextroamphetamine and methylphenidate during pregnancy was not significantly associated with autism spectrum disorder, ADHD, or any neurodevelopmental disorder in children after adjusting for confounding factors.
• The findings suggest that exposure to these stimulants during pregnancy is not likely to increase the risk of childhood neurodevelopmental disorders.

Stimulants for ADHD in Pregnancy

The research study investigated the association between prescription stimulant treatment for attention-deficit/hyperactivity disorder (ADHD) during pregnancy and the risk of neurodevelopmental disorders in children.

The study, which included 7065 pregnancies exposed to amphetamine/dextroamphetamine and 1123 pregnancies exposed to methylphenidate in the second half of pregnancy, found that neither medication was associated with autism spectrum disorder, ADHD, or any neurodevelopmental disorder in children after carefully adjusting for confounding factors through various design and analytic approaches.

The study used health care utilization data from publicly insured and commercially insured pregnant individuals in the United States. They monitored the children from birth until outcome diagnosis, disenrollment, death, or the end of the study.

The findings suggest that amphetamine/dextroamphetamine and methylphenidate exposure during pregnancy are not likely to significantly increase the risk of childhood neurodevelopmental disorders.

The main outcomes measured included autism spectrum disorder, ADHD, and a composite of any neurodevelopmental disorder.

• In unadjusted analyses, both amphetamine/dextroamphetamine and methylphenidate exposure were associated with a 2- to 3-fold increased risk of neurodevelopmental outcomes, but after adjustment for confounding factors, amphetamine/dextroamphetamine exposure was not associated with any of the outcomes considered.
• Methylphenidate exposure was associated with an increased risk of ADHD but not other outcomes after adjustment.
• However, in sensitivity analyses with stricter control for confounding by maternal ADHD, the association between methylphenidate and ADHD did not persist.
• Overall, the study’s findings suggest that exposure to amphetamine/dextroamphetamine and methylphenidate in utero is not likely to significantly increase the risk of childhood neurodevelopmental disorders.

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