NCRR - National Centre for Register-based Research, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark.
Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Mol Psychiatry. 2023 Apr;28(4):1739-1746. doi: 10.1038/s41380-023-01992-6. Epub 2023 Feb 9.
Attention Deficit Hyperactivity Disorder (ADHD) medication is increasingly being used during pregnancy. Concerns have been raised as to whether ADHD medication has long-term adverse effects on the offspring. The authors investigated whether in utero exposure to ADHD medication was associated with adverse long-term neurodevelopmental and growth outcomes in offspring. The population-based cohort study in the Danish national registers included 1,068,073 liveborn singletons from 1998 to 2015 followed until any developmental diagnosis, death, emigration, or December 31, 2018. Children of mothers who continued ADHD medication (methylphenidate, amphetamine, dexamphetamine, lisdexamphetamine, modafinil, atomoxetine, clonidine) during pregnancy and children of mothers who discontinued ADHD medication before pregnancy were compared using Cox regression. Main outcomes were neurodevelopmental psychiatric disorders, impairments in vision or hearing, epilepsy, seizures, or growth impairment during childhood or adolescence. In total, 898 children were exposed to ADHD medication during pregnancy compared to 1270 children whose mothers discontinued ADHD medication before pregnancy. After adjustment for demographic and psychiatric characteristics of the mother, no increased risk of any offspring developmental disorders was found combined (aHR 0.97, 95% CI 0.81 to 1.17) or for separate subcategories. Similarly, no increased risk was found for any sub-categories of outcomes in the negative control or sibling controlled analyses. Neurodevelopment and growth in offspring do not differ based on antenatal exposure to ADHD medication. These findings provide reassurance for women with ADHD who depend on ADHD medication for daily functioning and who consider continuing medication in pregnancy.
注意缺陷多动障碍 (ADHD) 药物在怀孕期间的使用越来越多。人们担心 ADHD 药物是否会对后代产生长期的不良影响。作者研究了宫内暴露于 ADHD 药物是否与后代的长期神经发育和生长结果不良有关。这项基于人群的队列研究在丹麦国家登记处进行,纳入了 1998 年至 2015 年间出生的 1068073 名单胎活产儿,随访至任何发育诊断、死亡、移民或 2018 年 12 月 31 日。比较了怀孕期间继续使用 ADHD 药物(哌醋甲酯、安非他命、右旋苯丙胺、右苯丙胺、莫达非尼、阿托西汀、可乐定)的母亲的孩子和怀孕前停止 ADHD 药物的母亲的孩子,使用 Cox 回归。主要结果是神经发育性精神障碍、视力或听力障碍、癫痫、癫痫发作或儿童期或青春期生长障碍。共有 898 名儿童在怀孕期间暴露于 ADHD 药物,而 1270 名儿童的母亲在怀孕前停止了 ADHD 药物。在校正了母亲的人口统计学和精神科特征后,联合使用 ADHD 药物并没有增加任何后代发育障碍的风险(aHR 0.97,95%CI 0.81 至 1.17)或单独的亚类。同样,在阴性对照或同胞对照分析中,也没有发现任何亚类别的结果风险增加。根据产前暴露于 ADHD 药物,后代的神经发育和生长没有差异。这些发现为依赖 ADHD 药物进行日常功能的 ADHD 女性提供了保证,她们考虑在怀孕期间继续使用药物。
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