ADHD medication in pregnancy: understanding the population and outcomes related to treatment use and discontinuation
Our aim is to assess risks of ADHD medication use or discontinuation during pregnancy to advise health professionals and women of childbearing age with ADHD and provide scientific innovations.
About the project
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Project period: 30.11.2020 - 31.12.2025 (Active)
- Coordinating Institution: Norwegian Institute of Public Health
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Project Manager:
- Jacqueline Mallory Cohen, Department of Chronic Diseases
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Project Participants:
- Carolyn E. Cesta, Karolinska Institutet
- Chaitra Srinivas, Department of Chronic Diseases
- Kari Furu, Department of Chronic Diseases
- Michael B. Lensing, Oslo University Hospital
- Helle Kieler, Karolinska Institutet
- Jennifer A Hutcheon, The University of British Columbia
- Olga Basso, McGill University
- Vidar Hjellvik, Department of Chronic Diseases
- Siri Eldevik Håberg, Centre for Fertility and Health
- Randi Marie Selmer, Department of Chronic Diseases
- Anders Engeland, Department of Global Public Health and Primary Care
- Øystein Karlstad, Department of Chronic Diseases
Summary
Our aim is to assess risks of ADHD medication use or discontinuation during pregnancy to advise health professionals and women of childbearing age with ADHD and provide scientific innovations.
ADHD became an increasingly common diagnosis among adults in the last two decades. The subsequent increase in ADHD medication use among women of childbearing age has been substantial. While we are concerned about the potential negative consequences of drug exposures in pregnancy, we should also weigh the risks of discontinuing effective treatment. Prior epidemiologic studies have identified increased risks of miscarriage and preterm birth related to ADHD treatment, but there are concerns about what is the appropriate comparison group and potential sources of bias that have been underexplored. For example, women with ADHD might be more likely to seek an induced abortion which would affect their risk of experiencing a miscarriage. The primary objective of the project is to assess whether ADHD medication use or discontinuation during pregnancy increase the risk of miscarriage, preterm birth, or postpartum depression. Secondary objectives explore potential sources of bias including risk of experiencing an induced abortion and describe how ADHD medications are used around the pregnancy period. The project uses data from health registries in Norway and Sweden and the Norwegian Mother, Father and Child Cohort Study (MoBa). We employ statistical methods that go beyond state of the art. The project is led by the Norwegian Institute of Public Health. A PhD student funded by RCN was employed in this project from 2021 to 2024. Collaborating partners are Karolinska Institutet (Sweden), University of Bergen, University of British Columbia (Canada) and McGill University (Canada). We interviewed members of the patient organization "ADHD Norway" for input on relevant topics. In communication with the field, decision makers, health professionals and patient groups, we may influence regulations, clinical advice and promote research on the safe use of ADHD medicines during pregnancy.