# Attention-deficit/hyperactivity disorder medication use and cardiometabolic conditions in pregnancy: a population-based cohort study

## TL;DR

This study finds that using ADHD medications during pregnancy may increase the risk of certain heart and metabolic issues, but it's unclear if the medications or ADHD itself is to blame.

## Contribution

The study is among the first to investigate the association between ADHD medication use during pregnancy and cardiometabolic conditions in a large population-based cohort.

## Key findings

- ADHD medication use during pregnancy was linked to higher risks of gestational hypertension and gestational diabetes.
- Risk estimates for preeclampsia and cardiometabolic medication use were slightly elevated but less certain.
- The study could not determine whether ADHD medications or the condition itself caused the increased risks.

## Abstract

Use of medications to treat attention-deficit/hyperactivity disorder (ADHD) is increasingly prevalent among women of reproductive age, but little is understood about their potential cardiometabolic effects in pregnancy. We aimed to examine associations between ADHD medication use and cardiometabolic conditions during pregnancy (gestational hypertension, preeclampsia, and gestational diabetes) and the pharmacological treatment thereof.

Linking statewide hospital and dispensing data, we conducted a population-based matched cohort study of women who gave birth between January 2014 and June 2021 in New South Wales, Australia (n = 312,697). We compared the incidence of cardiometabolic conditions and cardiometabolic medication use during pregnancy among women who used ADHD medications during pregnancy (n = 336) with a 1:10 matched cohort of unexposed women, and with women who used ADHD medications in the 12 months before pregnancy (n = 252). We used Poisson regression models to calculate risk ratios (RR) and 95% confidence intervals (CI), adjusting for sociodemographic and pregnancy-related factors.

Compared with unexposed women, women who used ADHD medications during pregnancy had an increased risk of gestational hypertension (adjusted RR: 1.76, 95% CI: 1.20–2.57) and gestational diabetes (aRR: 1.41, 95% CI: 1.09–1.82), with slightly elevated risk estimates for preeclampsia (aRR: 1.30, 95% CI: 0.82–2.05) and cardiometabolic medication use (aRR: 1.40, 95% CI: 0.97–2.01). Compared with women who used ADHD medications before pregnancy only, risk estimates attenuated for all outcomes except gestational diabetes (aRR: 1.76, 95% CI: 1.06–2.93).

Women using ADHD medications had an elevated incidence of cardiometabolic conditions during pregnancy, but it remains unclear to what extent this is attributable to medications rather than the underlying ADHD.

The online version contains supplementary material available at 10.1007/s00737-025-01664-0.

There is limited evidence regarding the cardiometabolic effects of ADHD medication use during pregnancy.In this population-based cohort study, we found that pregnant women who use ADHD medications may be at greater risk of gestational hypertension, preeclampsia and gestational diabetes.It is unclear whether or to what extent this represents an effect ofADHD medication as opposed to the underlying ADHD.

There is limited evidence regarding the cardiometabolic effects of ADHD medication use during pregnancy.

In this population-based cohort study, we found that pregnant women who use ADHD medications may be at greater risk of gestational hypertension, preeclampsia and gestational diabetes.

It is unclear whether or to what extent this represents an effect ofADHD medication as opposed to the underlying ADHD.

The online version contains supplementary material available at 10.1007/s00737-025-01664-0.