Anderson Kayla N, Ailes Elizabeth C, Danielson Melissa, Lind Jennifer N, Farr Sherry L, Broussard Cheryl S, Tinker Sarah C
MMWR Morb Mortal Wkly Rep. 2018 Jan 19;67(2):66-70. doi: 10.15585/mmwr.mm6702a3.
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that affects individuals across the lifespan. ADHD medication use among pregnant women is increasing (1), but consensus about the safety of ADHD medication use during pregnancy is lacking. Given that nearly half of U.S. pregnancies are unintended (2), and early pregnancy is a critical period for fetal development, examining trends in ADHD medication prescriptions among reproductive-aged women is important to quantify the population at risk for potential exposure. CDC used the Truven Health MarketScan Commercial Database* for the period 2003-2015 to estimate the percentage of women aged 15-44 years with private employer-sponsored insurance who filled prescriptions for ADHD medications each year. The percentage of reproductive-aged women who filled at least one ADHD medication prescription increased 344% from 2003 (0.9% of women) to 2015 (4.0% of women). In 2015, the most frequently filled medications were mixed amphetamine salts, lisdexamfetamine, and methylphenidate. Prescribing ADHD medications to reproductive-aged women is increasingly common; additional research on ADHD medication safety during pregnancy is warranted to inform women and their health care providers about any potential risks associated with ADHD medication exposure before and during pregnancy.
注意缺陷多动障碍（ADHD）是一种影响个体一生的神经发育障碍。孕妇中使用ADHD药物的情况正在增加（1），但对于孕期使用ADHD药物的安全性缺乏共识。鉴于美国近一半的怀孕是意外怀孕（2），且早孕是胎儿发育的关键时期，研究育龄妇女中ADHD药物处方的趋势对于量化有潜在暴露风险的人群很重要。美国疾病控制与预防中心（CDC）利用2003 - 2015年期间的Truven Health MarketScan商业数据库*来估计15 - 44岁有私人雇主赞助保险的女性中每年开具ADHD药物处方的百分比。开具至少一张ADHD药物处方的育龄女性百分比从2003年（占女性的0.9%）到2015年（占女性的4.0%）增长了344%。2015年，最常开具的药物是混合苯丙胺盐、赖右苯丙胺和哌甲酯。给育龄女性开具ADHD药物越来越普遍；有必要对孕期ADHD药物安全性进行更多研究，以便让女性及其医疗保健提供者了解孕期及孕前ADHD药物暴露的任何潜在风险。
