Prevalence of the Prescribing of Attention-Deficit Hyperactivity Disorder Medication During Pregnancy: A Systematic Review.

Abstract

Attention deficit hyperactivity disorder (ADHD) diagnosis in women has markedly increased in recent years, resulting in an increase of ADHD medication exposure during pregnancy, which has uncertain health risks. It is therefore critical to understand the extent of the issue. The objective of this novel systematic review was to investigate the prevalence of the prescribing of ADHD medication during pregnancy. A systematic review was conducted following preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. The last search was October 13, 2023, for articles examining the prescribing of ADHD medication in pregnancy. Fifteen studies were included. Participants from the United States (n = 4), the Nordic countries (n = 10), Canada (n = 3), and Australia (n = 1) were included. The prevalence of ADHD-medication dispensing during pregnancy ranged from 0.07 to 6.01 per 1,000 pregnancies. Typically, stimulant medications were more prevalent than nonstimulants. The most prevalent ADHD medication dispensed during pregnancy was methylphenidate followed by amphetamine-type medications. There was high heterogeneity (I² = 99.95%) between the studies, making the study data not appropriate for meta-analysis. The prevalence of the prescribing of ADHD medications in pregnancy ranged substantially, with psychostimulant medications most prescribed. Apart from in the Nordic countries, estimates of prevalence were limited.