Research that started as a student project has provided new evidence to guide use of ADHD medicines in pregnancy. Dr Andrea Sit, a junior medical doctor and recent Masters of Public Health (MPH) graduate, began the project as part of her MPH in late 2023 and it was published as a preprint late last year. Together with a team from the Medicines Intelligence Research Program at the UNSW Sydney School of Population Health, she used Australian linked hospital and prescription data to study a cohort of over 300,000 births between 2014 and 2021.
More and more adults are being diagnosed with ADHD, in Australia and internationally. As a result, the chance of unintentionally taking ADHD medicines during pregnancy has grown, along with questions about the balance of benefits and harms of continuing treatment after conception. Evidence to support decision-making has been lacking, with concerns that ADHD medicines, particularly stimulants such as dexamfetamine and methylphenidate (Ritalin), could cause pregnancy complications or affect child development.
Dr Sit’s study focussed on cardiometabolic conditions during pregnancy, high blood pressure and gestational diabetes (high blood sugar). She found that when compared to other, similar, pregnancies, these conditions were present more often when people were taking ADHD medicines. But this may not be a direct effect of ADHD medicines, as people with ADHD have other differences in their health that increase their risk of cardiometabolic disease. On the other hand, the increase in gestational diabetes was unexpected and more research is needed to explain it.
The project was made possible by the Medicines Intelligence Data Platform, an anonymised data resource covering over seven million Australians and accessed on a secure data analysis system, SURE. It links together several sources of Australian government data, collected for purposes such as monitoring hospital care and funding prescription medicines. The Medicines Intelligence Research Program uses the platform for population-based studies examining the use, safety and (cost)effectiveness of prescribed medicines, including contributions to the TIMESPAN project.
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