Pregnant women with ADHD can breathe a sigh of relief

The National Centre for Register-based Research at Aarhus BSS at Aarhus University has headed the study programme, and it is the largest of its kind so far. The researchers studied more than one million children born in Denmark between 1998 and 2015, and monitored them up to the end of 2018. They identified almost 900 children whose mothers continued treatment with ADHD medication throughout pregnancy, or who started on ADHD medication during pregnancy, and 1,270 children whose mothers stopped taking ADHD medication before pregnancy. These groups have been compared and the results are rather uplifting.

There is absolutely no higher risk of adverse developmental effects from the medication on children who have been exposed to ADHD medication during their mothers' pregnancy.

"This is not just good news for the mothers who have already had to take ADHD medication during their pregnancy. It’s also good news for the increasing number of women undergoing treatment with ADHD medication and who want to have a child," says Kathrine Bang Madsen, senior researcher at the National Centre for Register-based Research and the first author of the scientific article about the study, which has just been published in Molecular Psychiatry.

We can see that the number of women of childbearing age receiving ADHD medication is growing sharply, so it’s crucial that we get this knowledge out.

^{Kathrine Bang Madsen, senior researcher at the National Centre for Register-based Research and the first author of the scientific article about the study, which has just been published in Molecular Psychiatry.}

Globally, it has been estimated that more than one percent of pregnant women are on ADHD medication, and thus it is among the most commonly prescribed medications during pregnancy. However, there are a lot of fewer in the Nordic countries, because clinical guidelines have been very restrictive due to lack of evidence in the area.

Clinical guidelines

It is also good news for psychiatrists, general practitioners, midwives, health visitors and other healthcare professionals who advise pregnant women, but who lack clinical guidelines on pregnancy and ADHD medicine.

"We can see that the number of women of childbearing age receiving ADHD medication is growing sharply, so it’s crucial that we get this knowledge out. We know that there’s an increased risk of depression and accidents if people with ADHD don’t take medication. Similarly, there’s a higher risk of not being able to maintain a job. Therefore, advice for these women is extremely important," says Kathrine Bang Madsen.

The researchers examined whether the children had developed neurological developmental disorders, including autism and ADHD, impaired vision or hearing, epilepsy, febrile seizure or growth impairment.

"Only a thin membrane separates the mother's blood from the blood of the foetus. This means that medication of a certain concentration in the mother's blood can cross through the membrane and pass through the umbilical cord to the fetus. We know from animal tests that stimulant treatments (methylphenidate and amphetamine), which are the most frequently used in ADHD, can pass to the fetus and therefore there has been concern about whether they could harm the child's neural development and growth," explains Kathrine Bang Madsen.

She stresses that the study should be followed up with additional research to examine whether there are differences between the individual types of ADHD medication.