The Course of ADHD during Pregnancy.

OBJECTIVE: The aim of this study was to characterize the course of ADHD during pregnancy. METHOD: Women ages 18 to 45 were followed prospectively at <20 weeks, 24 weeks, and 36 weeks pregnant. Three groups emerged: women who discontinued, maintained, or adjusted their ADHD medications. ADHD symptoms were recorded using the AISRS. Anxiety, depression, stress, and functional impairment were monitored. RESULTS: A total of 25 women with ADHD were eligible for analysis. No significant difference observed between three groups in AISRS scores. Significant differences found between medication discontinuers vs adjusters for both mood and family functioning (EPDS, 5.3, p < .0001; WFIRS, 3.3, p = .0309). Significant differences also found between discontinuers vs maintainers for mood and family functioning (EPDS, 4.98, p = .0009; WFIRS, 3.09, p = .0197). CONCLUSION: This preliminary study provides novel insight into the course of ADHD during pregnancy, underscoring mood and family functioning as critical domains that may contribute to growing use of psychostimulants during pregnancy.

Management of Attention Deficit Hyperactivity Disorder During Pregnancy.

Attention deficit hyperactivity disorder (ADHD) is a common neurobehavioral disorder affecting 3.2% of women. More women are taking psychostimulant medications, including during pregnancy. Although stimulant use does not appear to be associated with congenital malformations, there are inconsistent data about other obstetric risks, and no long-term neurodevelopmental data exist to inform clinical management decisions. This article summarizes the available data regarding perinatal exposure to psychostimulants. It also highlights the importance of the risk-risk analysis for clinicians and patients to consider, weighing risks of medication exposure to risks of ADHD during pregnancy, including driving safety and major impairment in occupational roles.