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In utero exposure to methylphenidate, amphetamines and atomoxetine and offspring neurodevelopmental disorders - a

Kathrine Bang Madsen1,2,3, Henrik Larsson4,5, Charlotte Skoglund6,7

  • 1Department of Clinical Research, University of Southern Denmark, Odense, Denmark. kbmadsen@health.sdu.dk.

Molecular Psychiatry
|March 28, 2025
PubMed

Insights

In utero exposure to Attention-Deficit/Hyperactivity Disorder (ADHD) medications like methylphenidate, amphetamines, and atomoxetine does not increase the risk of neurodevelopmental disorders in children. This large-scale study provides crucial safety data for expectant mothers and healthcare providers.

Area of Science:

  • Neuroscience
  • Developmental Pediatrics
  • Pharmacology

Background:

  • Increasing use of ADHD medications during pregnancy raises concerns about potential long-term effects on offspring neurodevelopment.
  • Existing data on the safety of prenatal exposure to ADHD medications is limited, particularly for newer treatments like atomoxetine and amphetamines.

Purpose of the Study:

  • To investigate the association between in utero exposure to methylphenidate, amphetamines, and atomoxetine and the risk of neurodevelopmental disorders (NDDs) in offspring.
  • To provide robust evidence to inform clinical guidelines and decision-making for pregnant individuals using ADHD medications.

Main Methods:

  • A population-based cohort study utilizing Swedish registers, including 861,650 children born between 2008-2017.
  • Exposure categorized by redeemed medication during pregnancy; outcomes included any NDD, ADHD, and autism spectrum disorder (ASD).
  • Statistical analyses included Cox proportional hazards regression, sensitivity analyses (medication type, timing, duration, sibling comparisons), and meta-analysis with a Danish study.

Main Results:

  • No statistically significant increased risk was observed for any NDD (aHR 0.95), ADHD (aHR 0.92), or ASD (aHR 0.86) in children exposed in utero.
  • Sensitivity analyses and meta-analyses consistently supported the absence of increased NDD risk across various exposure scenarios.
  • The study replicates and extends safety data for methylphenidate, amphetamines, and atomoxetine regarding prenatal exposure.

Conclusions:

  • In utero exposure to common ADHD medications is not associated with an increased risk of long-term neurodevelopmental disorders in offspring.
  • Findings support the safe use of these medications during pregnancy when clinically indicated.
  • This research offers critical evidence for healthcare providers and expectant mothers to make informed treatment decisions.

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