Adult ADHD
Visual Abstract
Association Between Methylphenidate and Amphetamine Use in Pregnancy and Risk of Congenital Malformations
Ritalin, Adderall, and Risks in Pregnancy
Krista F. Huybrechts, MS, PhD,corresponding author Gabriella Bröms, MD, PhD, Lotte Brix Christensen, MSc, Kristjana Einarsdóttir, PhD,, Anders Engeland, MSc, PhD,, Kari Furu, MScPharm, MPH, PhD, Mika Gissler, PhD,,, Sonia Hernandez-Diaz, MD, DrPH, Pär Karlsson, MSc, Øystein Karlstad, MScPharm, PhD, Helle Kieler, MD, PhD, Anna-Maria Lahesmaa-Korpinen, PhD, Helen Mogun, MS, Mette Nørgaard, MD, PhD, Johan Reutfors, MD, PhD, Henrik Toft Sørensen, DMSc, PhD, Helga Zoega, MA, PhD,, and Brian T. Bateman, MD, MSc,
Summarized by:
May 13, 2023
study source
JAMA Psychiatry
Feb 2018
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What they studied
The study wanted to see whether stimulant medications for ADHD were linked with birth defects.
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What they found
Exposure to Ritalin in the womb was linked with a small increase in the risk of heart defects.
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What this means
These data may be useful in helping expectant mothers with ADHD choose the best treatment option.
Association Between Methylphenidate and Amphetamine Use in Pregnancy and Risk of Congenital Malformations
Objectives
Adult ADHD is rapidly growing in recognition. As a result, many more adults, including expectant mothers, are receiving treatment for it, particularly stimulant medications, the most commonly prescribed medication for ADHD.
This study wanted to examine whether stimulant medications for pregnant mothers posed a risk for developing fetuses.
Study Quote
Importance Given the rapidly increasing use of stimulant medications during pregnancy and among women of reproductive age who may become pregnant inadvertently, there is a need to better understand their safety. Objective To examine the risk of congenital malformations associated with i...
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Methods
Researchers analyzed nearly two million pregnancies across the United States and Nordic countries in Europe to study this.
They examined rates of birth defects, particularly defects of the heart, among infants who were exposed to stimulant medication.
Study Quote
Design, Setting, and Participants:
Cohort study of the Medicaid-insured population in the United States nested in the 2000-2013 US Medicaid Analytic eXtract, with follow-up of safety signals detected in the Medicaid Analytic eXtract data using the Nordic Health registries (2003-2013)...
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Results
Upon initial analysis, the data showed that infants exposed to Ritalin andAdderall in the womb had slightly higher rates of birth abnormalities.
However, once researchers controlled for confounding variables, this effect was no longer statistically significant.
Why do researchers adjust for variables?
When researchers analyzed heart defects specifically, they found a slight increase in the risk of heart defects among mothers, who had taken Ritalin, but not Adderall:
A large study found that mothers who had taken Ritalin during pregnancy were slightly more likely to have babies with heart defects.
Study Quote
In the US data, of the 1 813 894 pregnancies evaluated, 35.0 per 1000 infants not exposed to stimulants were diagnosed as having congenital malformations, compared with 45.9 per 1000 infants for methylphenidate and 45.4 for amphetamines. For cardiac malformations, the risks were 12.7 (95...
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Conclusions
Based on the study's results, the researchers concluded that exposure to Ritalin in the womb was linked to a small increase in heart defect risk.
This risk was on the border of statistical significance. It’s possible that our understanding of this link may change with future studies.
Given the fact that there are many treatment options for adults with ADHD that aren’t linked with risk during pregnancy, including similar stimulants such as Adderall, this research may be useful in helping expectant mothers and their healthcare providers select the best treatment for their case.
Study Quote
These findings suggest a small increase in the risk of cardiac malformations associated with intrauterine exposure to methylphenidate but not to amphetamines. This information is important when weighing the risks and benefits of alternative treatment strategies for attention-deficit/hype...
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