According to a study that examined the effects of prenatal ADHD medication exposure, ADHD medication usage during pregnancy didn't increase rates of neurodevelopment and growth impairments among children.

According to a large population-based study, in utero exposure to ADHD medications, including stimulants, did not affect a child's growth or neurodevelopment compared to those whose mothers had stopped taking ADHD medication before conception.

The research was conducted by using data from the Danish national registers. This included more than a million children born in Denmark between 1998 and 2015. The "exposed group" of the study included 898 children whose mothers had started or continued to take ADHD medications during pregnancy. The "unexposed group" included 1,270 children whose mothers had stopped taking ADHD medication but had previously taken it before conception.

Prenatal and Postnatal exposure to ADHD medication

Researchers found that after adjusting for maternal characteristics and psychiatric information, there was no difference between the two groups regarding long-term growth or neurodevelopmental outcomes. Therefore, women could continue taking their medication during pregnancy or stop before conception without increasing the risk for neurodevelopmental disorders such as ADHD, ASD or neurodevelopmental impairments like seizures, epilepsy, or vision impairments.

ADHD medication is the most commonly prescribed medication during pregnancy.3,4

A recent survey of Attitude users found that 2.39% (1,170) of pregnant women had taken medication to treat their ADHD after conception. Many women who didn't take medication claimed they were not diagnosed and untreated when they became pregnant, so they had no prescription medications. Only 2.58% of women who were breastfeeding took ADHD medication.

If a pregnant woman chooses to stop using the medication while breastfeeding, she may go for a year without receiving pharmacological therapy -- a primary treatment for ADHD.

One woman, 33 years old from Texas, wrote: "I stopped taking Adderall before my delivery and was told that I could not take it during breastfeeding." "I returned to work three months postpartum. I struggled with symptoms and felt like I couldn't do my job.

"I did additional research... which suggested a low rate of breastmilk transfer for Adderall and an even lower level with Ritalin. Five months after my daughter was born, I presented this data to my GP, who prescribed 5mg of Ritalin two times daily. After two months of exclusively breastfeeding, I switched to formula and breastfeeding until my daughter reached nine months. My GP then hit me back on Adderall. My daughter had no adverse effects during this period and continued to grow at the 90th percentile while sleeping well.

Children's Impact

It is not easy to decide whether or not to continue ADHD medication during pregnancy, mainly because the effects in utero of ADHD medications are not well documented. The nature of the problem means that research is limited to studies such as this one, which is the second and most extensive long-term registered study to examine the effects of ADHD medication while pregnant.

The research is also contradictory. For example, a 2015 U.S. study of a population found that ADHD medication used in early pregnancy is associated with specific congenital disabilities.

Researchers found that while exposed children did not face an increased risk for neurodevelopmental outcomes, they were more susceptible to ADHD if their mothers had taken other psychotropic medications during pregnancy. In addition, researchers found this was also true when the mother filled at least two prescriptions for ADHD medication while pregnant.

Researchers speculate that the results could be due to "a higher disease liability for ADHD as well as referral bias" because the offspring of mothers with severe ADHD may be assessed more closely for ADHD.

Women with ADHD and Their Impact

In the Attitude study, around this age, women begin to report that their ADHD symptoms have a significant impact on their lives. According to the I>ADDitude/I> survey, women say that their 'ADHD-symptoms-checklist/' significantly impacts them in their 20s or 30s.

The ADHD symptoms of half the respondents to a survey who were pregnant remained unchanged during pregnancy. However, after delivery, 56.7% reported experiencing symptoms of Postpartum Depression. Over a third of women told Attitude that these symptoms continued for six months. For nearly 10%, the postpartum depression symptoms lasted over two years.

A survey from 2020 conducted by the MGH Center for Women's Mental Health revealed similar findings. Women did not report any significant changes to their ADHD symptoms during pregnancy. However, those women who discontinued psychostimulant medications experienced increased depressive symptoms after delivery. Women who chose to maintain the same ADHD prescription schedule or adjust their medication dosage did not notice a significant difference in depressive symptoms.

Limitations and Future Research

Researchers stated that pregnant women dependent on stimulants to function daily must weigh potential risks to their fetus against the medical, financial and other effects to mother and child associated with the exacerbation in ADHD symptoms after stopping the medication. These include the inability to keep a job and unsafe driving.

The present study examined the effects of ADHD medications, including stimulants, such as methylphenidate (amphetamine), dexamphetamine (lisdexamfetamine), and modafinil (atomoxetine), clonidine, and modafinil (atomoxetine).

The present study confirms that antenatal stimulant use does not affect the outcome of several categories that might be reasonably suspected to be involved, such as body growth, neurodevelopment and seizure risks.

The study's sample of women who have ADHD tends to be younger than women without ADHD at the time of birth, more likely to smoke during pregnancy, and more likely to give birth to children preterm or low weight. The findings were the same whether or not the mother was taking ADHD medication while pregnant.

Finally, further research is required to distinguish between the effects of ADHD medication types, dosages, and trimesters. This study only included diagnoses that were formally recorded in the Danish registry. In the future, research should consist of a broader sample of people.