Investigating maternal and neonatal health outcomes associated with continuing or ceasing dexamphetamine treatment for women with attention-deficit hyperactivity disorder during pregnancy: a retrospective cohort study

• Published in: Archives of women's mental health 2024-10, Vol.27 (5), p.785-794
• Main Authors: Russell, Danielle J., Wyrwoll, Caitlin S., Preen, David B., Kelty, Erin
• Format: Article
• Language: English
• Subjects: Abortion; Adult; Attention Deficit Disorder with Hyperactivity - drug therapy; Attention deficit hyperactivity disorder; Central Nervous System Stimulants - administration & dosage; Central Nervous System Stimulants - adverse effects; Central Nervous System Stimulants - therapeutic use; Cohort Studies; Dextroamphetamine - adverse effects; Dextroamphetamine - therapeutic use; Female; Fetuses; Hemorrhage; Humans; Infant Health; Infant, Newborn; Medicine; Medicine & Public Health; Neonates; Original; Original Article; Population studies; Pre-eclampsia; Pregnancy; Pregnancy complications; Pregnancy Complications - drug therapy; Pregnancy Outcome - epidemiology; Psychiatry; Psychotherapy; Retrospective Studies; Western Australia - epidemiology; Womens health
• ISSN: 1434-1816; 1435-1102; 1435-1102
• DOI: 10.1007/s00737-024-01450-4

Purpose Attention-deficit hyperactivity disorder (ADHD) is becoming more commonly diagnosed in women, consequently, more women of reproductive age are taking ADHD medication, such as dexamphetamine. However, the safety associated with continuing or ceasing dexamphetamine during pregnancy is unclear. This study investigates outcomes associated with the continuation of dexamphetamine during pregnancy compared to those who ceased or were unexposed. Methods A population-based retrospective cohort of women from Western Australia who had been dispensed dexamphetamine during pregnancy and gave birth between 2003 and 2018. Women had either continued to take dexamphetamine throughout pregnancy (continuers, n  = 547) or ceased dexamphetamine before the end of the second trimester (ceasers, n  = 297). Additionally, a matched (1:1) comparison group of women who were dispensed an ADHD medication prior to pregnancy but not during pregnancy (unexposed) was included in the study ( n  = 844). Multivariable generalised linear models were used to compare maternal and neonatal health outcomes. Results Compared to continuers, ceasers had greater odds of threatened abortion (OR: 2.28; 95%CI: 1.00, 5.15; p  = 0.049). The unexposed had some benefits compared to the continuers, which included lower risk of preeclampsia (OR: 0.58; 95%CI: 0.35, 0.97; p  = 0.037), hypertension (OR: 0.32; 95%CI: 0.11, 0.93; p  = 0.036), postpartum haemorrhage (OR: 0.57; 95%CI: 0.41, 0.80; p  = 0.001), neonatal special care unit admittance (OR: 0.16; 95%CI: 0.12, 0.20; p