ADHD Med use During Pregnancy and Risk of Birth Defects

Researchers find small increase in the risk of heart defects following first-trimester exposure to Methylphenidate but not to amphetamines

A new study leverages data from multiple large cohorts to define and quantify what, if any, increased risk may be posed by taking the most commonly used ADHD medications. The team found that one medication, methylphenidate, increased risk of heart defects by a small amount while another medication, amphetamines, did not.

Adults, including women of reproductive age, are increasingly being prescribed medications to treat Attention Deficit Hyperactivity Disorder (ADHD) but little evidence has been available about whether exposure to these drugs during early pregnancy may increase the risk of birth defects. A new study conducted by investigators leverages data from multiple large cohorts to define and quantify what, if any, increased risk may be posed by taking the most commonly used ADHD medications. The team found that one medication, methylphenidate, increased risk of heart defects by a small amount while another medication, amphetamines, did not.

Animal studies of very high doses of amphetamines had suggested a potential risk of increased heart defects and other birth defects, but data regarding safety in human offspring had been limited. The new work makes use of data from 1.8 million pregnancies in the U.S. Among the women in this cohort, more than 2,700 filled a prescription for methylphenidate during their first trimester of pregnancy, and more than 5,500 filled one for amphetamines. The team validated their findings by also examining data from a cohort of 2.5 million pregnancies from Nordic registries.

Overall, based on both populations, the team found a 28 percent increased risk of heart malformations after first-trimester exposure to methylphenidate. This increase corresponds to three additional infants born with congenital heart defects for every 1,000 women treated with methylphenidate during the first trimester of pregnancy. No association was observed for methylphenidate and congenital birth defects overall, or for amphetamines and any congenital or heart defect.

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