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In utero exposure to ADHD medication and long-term offspring outcomes

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  • Kathrine Bang Madsen
  • Thalia K Robakis, Icahn School of Medicine at Mount Sinai
  • ,
  • Xiaoqin Liu
  • Natalie Momen
  • Henrik Larsson, Örebro University, Karolinska Institutet
  • ,
  • Julie Werenberg Dreier
  • Helene Kildegaard, University of Southern Denmark
  • ,
  • Jane Bjerg Groth, Zealand University Hospital
  • ,
  • Jeffrey H Newcorn, Icahn School of Medicine at Mount Sinai
  • ,
  • Per Hove Thomsen
  • Trine Munk-Olsen
  • Veerle Bergink, Icahn School of Medicine at Mount Sinai, Department of Psychiatry, Erasmus Medical Centre, Rotterdam, Netherlands

Attention Deficit Hyperactivity Disorder (ADHD) medication is increasingly being used during pregnancy. Concerns have been raised as to whether ADHD medication has long-term adverse effects on the offspring. The authors investigated whether in utero exposure to ADHD medication was associated with adverse long-term neurodevelopmental and growth outcomes in offspring. The population-based cohort study in the Danish national registers included 1,068,073 liveborn singletons from 1998 to 2015 followed until any developmental diagnosis, death, emigration, or December 31, 2018. Children of mothers who continued ADHD medication (methylphenidate, amphetamine, dexamphetamine, lisdexamphetamine, modafinil, atomoxetine, clonidine) during pregnancy and children of mothers who discontinued ADHD medication before pregnancy were compared using Cox regression. Main outcomes were neurodevelopmental psychiatric disorders, impairments in vision or hearing, epilepsy, seizures, or growth impairment during childhood or adolescence. In total, 898 children were exposed to ADHD medication during pregnancy compared to 1270 children whose mothers discontinued ADHD medication before pregnancy. After adjustment for demographic and psychiatric characteristics of the mother, no increased risk of any offspring developmental disorders was found combined (aHR 0.97, 95% CI 0.81 to 1.17) or for separate subcategories. Similarly, no increased risk was found for any sub-categories of outcomes in the negative control or sibling controlled analyses. Neurodevelopment and growth in offspring do not differ based on antenatal exposure to ADHD medication. These findings provide reassurance for women with ADHD who depend on ADHD medication for daily functioning and who consider continuing medication in pregnancy.

Original languageEnglish
JournalMolecular Psychiatry
Pages (from-to)1739-1746
Number of pages8
Publication statusPublished - Apr 2023

Bibliographical note

© 2023. The Author(s), under exclusive licence to Springer Nature Limited.

    Research areas

  • Adolescent, Attention Deficit Disorder with Hyperactivity/etiology, Child, Cohort Studies, Female, Humans, Methylphenidate/adverse effects, Mothers, Pregnancy, Prenatal Exposure Delayed Effects/epidemiology

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