SOMANZ Poster Presentation Australasian Diabetes in Pregnancy Society and Society of Obstetric Medicine Australia and New Zealand Joint Scientific Meeting 2025

Attention-deficit/hyperactivity disorder medication use and cardiometabolic conditions in pregnancy: A population-based cohort study  (#143)

Andrea Sit 1 2 3 , Claudia Bruno 1 4 5 6 , Malcolm B. Gillies 1 , Masako Araki 1 , Helga Zoega 7
  1. School of Population Health, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
  2. Royal Prince Alfred Hospital, Camperdown, NSW, Australia
  3. School of Medicine, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW
  4. Leeder Centre for Health Policy, Economics and Data, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
  5. Child Population and Translational Health Research, Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
  6. Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
  7. Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik, Iceland

Background 

Medications for attention-deficit/hyperactivity disorder (ADHD) are used increasingly among women of reproductive age, yet little is understood about their effects in pregnancy. We investigated potential associations between ADHD medication use and cardiometabolic conditions during pregnancy–gestational hypertension, preeclampsia and gestational diabetes. 

Methods 

We conducted a population-based matched cohort study using linkage of the NSW Admitted Patient Data Collection and Pharmaceutical Benefits Scheme dispensing data. We included women in NSW, Australia, who gave birth between January 2014 and June 2021. We compared the prevalence of cardiometabolic conditions and new cardiometabolic medication use during pregnancy among women who used ADHD medications during pregnancy (n=366) with a 1:10 matched cohort of unexposed women, and with women who had used ADHD medications in the 12 months before but not during pregnancy (n=252). We used Poisson regression models adjusted for sociodemographic and pregnancy-related factors. 

Results 

Compared with unexposed women, women who used ADHD medications during pregnancy had increased risks of gestational hypertension (RR: 1.76, 95% CI: 1.20-2.57), gestational diabetes (RR: 1.41, 95% CI: 1.09-1.82), and slightly elevated risk estimates for preeclampsia (RR: 1.30, 95% CI: 0.82-2.05) and new cardiometabolic medication use (RR: 1.40, 95% CI: 0.97-2.01). Compared with women who used ADHD medications before pregnancy only, they had a greater risk of gestational diabetes (RR: 1.76, 95% CI: 1.06-2.93). 

Conclusions 

Our findings suggest that women using ADHD medications have higher incidence of some cardiometabolic conditions during pregnancy; it remains unclear to what extent these associations are attributable to the medications or the underlying ADHD itself.