Attention-Deficit Hyperactivity Disorder (ADHD) Medication Use Trajectories Among Women in the Perinatal Period.

IF 7.4 2区医学 Q1 CLINICAL NEUROLOGY

CNS drugs Pub Date : 2024-04-01 Epub Date: 2024-03-15 DOI:10.1007/s40263-024-01076-1

Kathrine Bang Madsen, Mette Bliddal, Charlotte Borg Skoglund, Henrik Larsson, Trine Munk-Olsen, Malene Galle Madsen, Per Hove Thomsen, Veerle Bergink, Chaitra Srinivas, Jacqueline M Cohen, Isabell Brikell, Xiaoqin Liu

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引用次数: 0

Abstract

Background: An increasing number of women of reproductive age are treated with attention-deficit hyperactivity disorder (ADHD) medication; however, patterns of ADHD medication use for women in the perinatal period have not been well described.

Objective: This study aimed to describe ADHD medication use patterns from 1 year before pregnancy to 1 year after delivery, and to describe sociodemographic characteristics and clinical features by medication trajectories.

Methods: The population-based cohort study included pregnancies in Denmark between 1997 and 2020, from the Medical Birth Register, by women who filled at least one prescription for ADHD medication from 12 months before pregnancy until 12 months after delivery. We applied group-based trajectory modeling to classify women into subgroups based on the identification of heterogeneous ADHD medication treatment patterns, and described the characteristics associated with these groups.

Results: Overall, we included 4717 pregnancies leading to liveborn singletons by 4052 mothers with a mean (standard deviation) age of 27.5 (5.6) years. We identified four treatment trajectories across pregnancy and the postpartum period: continuers (23.3%), discontinuers (41.8%), interrupters who ceased filling prescriptions during pregnancy but resumed postpartum (17.2%), and postpartum initiators (17.7%). Continuers were older at the time of conception, gave birth in more recent years, were more likely to smoke during pregnancy, and used other psychotropic medications during pregnancy. A large proportion of continuers used methylphenidate (89.1%) compared with the other groups (75.9-84.1%) and had switched ADHD medication type during the whole period (16.4% vs. 7.4-14.8%).

Conclusion: We found that approximately 60% of women discontinued or interrupted their ADHD medication around pregnancy, and those who continued differed in sociodemographic and clinical factors that may reflect more severe ADHD.

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查看原文本刊更多论文

围产期妇女使用注意力缺陷多动障碍 (ADHD) 药物的轨迹。

背景：越来越多的育龄妇女接受注意力缺陷多动障碍（ADHD）药物治疗；然而，围产期妇女使用ADHD药物的模式尚未得到很好的描述：本研究旨在描述从怀孕前 1 年到分娩后 1 年的多动症用药模式，并根据用药轨迹描述社会人口学特征和临床特征：这项基于人群的队列研究纳入了 1997 年至 2020 年期间在丹麦怀孕的妇女，她们在怀孕前 12 个月至分娩后 12 个月期间至少开过一次 ADHD 药物处方。我们采用基于群体的轨迹模型，在确定不同ADHD药物治疗模式的基础上，将妇女划分为不同的亚组，并描述了这些亚组的相关特征：总体而言，我们共纳入了 4717 例妊娠，这些妊娠导致 4052 名平均（标准差）年龄为 27.5 (5.6) 岁的母亲活产了单胎。我们确定了孕期和产后的四种治疗轨迹：持续治疗者（23.3%）、中断治疗者（41.8%）、孕期停止处方但产后恢复治疗的中断治疗者（17.2%）和产后开始治疗者（17.7%）。继续用药者受孕时年龄较大，分娩时间较近，更有可能在怀孕期间吸烟，并在怀孕期间使用其他精神药物。与其他组别（75.9%-84.1%）相比，大部分持续用药者使用哌醋甲酯（89.1%），并且在整个孕期更换了多动症药物类型（16.4% 对 7.4%-14.8%）：我们发现，约有 60% 的妇女在怀孕前后停止或中断了多动症药物治疗，而那些继续服药的妇女在社会人口学和临床因素方面存在差异，这可能反映出多动症更为严重。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

CNS drugs 医学-精神病学

CiteScore

12.00

自引率

3.30%

发文量

审稿时长

6-12 weeks

期刊介绍： CNS Drugs promotes rational pharmacotherapy within the disciplines of clinical psychiatry and neurology. The Journal includes: - Overviews of contentious or emerging issues. - Comprehensive narrative reviews that provide an authoritative source of information on pharmacological approaches to managing neurological and psychiatric illnesses. - Systematic reviews that collate empirical evidence to answer a specific research question, using explicit, systematic methods as outlined by the PRISMA statement. - Adis Drug Reviews of the properties and place in therapy of both newer and established drugs in neurology and psychiatry. - Original research articles reporting the results of well-designed studies with a strong link to clinical practice, such as clinical pharmacodynamic and pharmacokinetic studies, clinical trials, meta-analyses, outcomes research, and pharmacoeconomic and pharmacoepidemiological studies. Additional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in CNS Drugs may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand important medical advances.