Attention-deficit/hyperactivity disorder in pregnancy and the postpartum period.

Journal: American journal of obstetrics and gynecology

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Affiliated Institutions:  University of British Columbia (UBC), Vancouver, BC, Canada. Department of Psychiatry, UBC, Vancouver, BC, Canada; Reproductive Mental Health Program, BC Women's Hospital, Vancouver, BC, Canada; BCCH Centre for Mindfulness, BC Children's Hospital, Vancouver, BC, Canada; BC Women's Health Research Institute, Vancouver, BC, Canada. BC Women's and Children's Hospital, Vancouver, BC, Canada. Department of Psychiatry, UBC, Vancouver, BC, Canada; Reproductive Mental Health Program, BC Women's Hospital, Vancouver, BC, Canada. Department of Psychiatry, SUNY Upstate Medical University, Syracuse, NY. Private practice, Newport Beach, CA. Department of Obstetrics & Gynaecology, UBC, Vancouver, BC, Canada; Reproductive Mental Health Program, BC Women's Hospital, Vancouver, BC, Canada; BC Women's Health Research Institute, Vancouver, BC, Canada; University of Calgary, Calgary, AB, Canada. Electronic address: catriona.hippman@ubc.ca.

Abstract summary 

Attention-deficit/hyperactivity disorder is a childhood-onset neurodevelopmental disorder that frequently persists into adulthood with 3% of adult women having a diagnosis of attention-deficit/hyperactivity disorder. Many women are diagnosed and treated during their reproductive years, which leads to management implications during pregnancy and the postpartum period. We know from clinical practice that attention-deficit/hyperactivity disorder symptoms frequently become challenging to manage during the perinatal period and require additional support and attention. There is often uncertainty among healthcare providers about the management of attention-deficit/hyperactivity disorder in the perinatal period, particularly the safety of pharmacotherapy for the developing fetus. This guideline is focused on best practices in managing attention-deficit/hyperactivity disorder in the perinatal period. We recommend (1) mitigating the risks associated with attention-deficit/hyperactivity disorder that worsen during the perinatal period via individualized treatment planning; (2) providing psychoeducation, self-management strategies or coaching, and psychotherapies; and, for those with moderate or severe attention-deficit/hyperactivity disorder, (3) considering pharmacotherapy for attention-deficit/hyperactivity disorder, which largely has reassuring safety data. Specifically, providers should work collaboratively with patients and their support networks to balance the risks of perinatal attention-deficit/hyperactivity disorder medication with the risks of inadequately treated attention-deficit/hyperactivity disorder during pregnancy. The risks and impacts of attention-deficit/hyperactivity disorder in pregnancy can be successfully managed through preconception counselling and appropriate perinatal planning, management, and support.

Authors & Co-authors:  Scoten Tabi Paquette Carrion Ryan Radonjic Whitham Hippman

Study Outcome 

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Statistics
Citations : 
Authors :  8
Identifiers
Doi : S0002-9378(24)00376-4
SSN : 1097-6868
Study Population
Women
Mesh Terms
Other Terms
ADHD;amphetamine;atomoxetine;breast milk;buproprion;clonidine;dextroamphetamine;guanfacine;lactation;lisdexamfetamine;mental health;methylphenidate;nonstimulants;pharmacotherapy;postpartum;pregnancy;stimulants;therapy;viloxazine
Study Design
Study Approach
Country of Study
Publication Country
United States