Prevalence Trends and Patterns of Perinatal ADHD Stimulant Medication Use in British Columbia, Canada.

IF 2.4 4区医学 Q3 PHARMACOLOGY & PHARMACY

Pharmacoepidemiology and Drug Safety Pub Date : 2025-04-01 DOI:10.1002/pds.70129

Amanda Nitchske, Ali Salmanpour, Paramdeep Kaur, Helena Abreu do Valle, Chelsea Elwood, Anne Gadermann, Martin Guhn, Catriona Hippman, Angie Ip, Jalisa L Karim, Tim F Oberlander, Peter M Socha, Gillian E Hanley

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引用次数: 0

Abstract

Purpose: Given the increase in attention-deficit/hyperactivity disorder (ADHD) diagnoses and stimulant medication use among female adults, this study describes the prevalence trends of perinatal ADHD stimulant medication use in British Columbia, Canada, along with characteristics and patterns of use.

Methods: Using linked population-based administrative data, we included all pregnant people with deliveries between January 2000 and December 2021. ADHD stimulant medication use was defined as filled prescriptions for dextro-/amphetamine, methylphenidate, or lisdexamfetamine. Prevalence trends were examined by medication type and age group. Characteristics were compared between those with and without prenatal stimulant medication dispensations. Patterns of use and discontinuation were assessed from 1 year preconception to 1 year postpartum.

Results: Our cohort included 899,679 pregnancies. Prenatal ADHD stimulant medication use increased by 3.9 users per 1000 pregnancies (from 0.4 to 4.3/1000), primarily driven by dextro-/amphetamine. Medication use increased among all age groups, but was highest among pregnant people under 20 years old. Pregnant people taking stimulant medications were more likely to be nulliparous and lower in income, have hypertension and higher BMI, smoke during pregnancy, use other psychotropic medications, and deliver by cesarean section. Among those who used stimulant medications within 1 year preconception, 77% discontinued treatment before or during pregnancy. While use increased again within 12 months postpartum, it remained 45% lower than preconception levels.

Conclusion: The 11-fold increase in ADHD stimulant medication use during pregnancy and the high rate of discontinuation highlight the need for more research on the risks and benefits of medication for parent and child health.

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加拿大不列颠哥伦比亚省围产期ADHD兴奋剂药物使用的流行趋势和模式。

目的：鉴于成年女性中注意力缺陷多动障碍（ADHD）诊断和兴奋剂药物使用的增加，本研究描述了加拿大不列颠哥伦比亚省围产期ADHD兴奋剂药物使用的流行趋势，以及使用的特点和模式。方法：使用相关的基于人口的行政数据，我们纳入了2000年1月至2021年12月期间分娩的所有孕妇。ADHD兴奋剂药物的使用被定义为右旋/安非他明、哌醋甲酯或利地安非他明的处方。按药物类型和年龄组检查流行趋势。比较有和没有产前兴奋剂药物分配的特征。从孕前1年到产后1年评估使用和停药模式。结果：我们的队列包括899,679例妊娠。产前ADHD兴奋剂药物的使用增加了3.9 /1000（从0.4 /1000增加到4.3/1000），主要是由右旋/安非他明驱动的。药物使用在所有年龄组中都有所增加，但在20岁以下的孕妇中最高。服用兴奋剂的孕妇更有可能无法生育，收入更低，有高血压和更高的身体质量指数，怀孕期间吸烟，使用其他精神药物，剖腹产。在孕前1年内使用兴奋剂药物的人中，77%在怀孕前或怀孕期间停止治疗。虽然在产后12个月内再次增加，但仍比孕前水平低45%。结论：怀孕期间使用ADHD兴奋剂药物的人数增加了11倍，停药率很高，这表明有必要对药物对父母和儿童健康的风险和益处进行更多的研究。

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

Pharmacoepidemiology and Drug Safety 医学-药学

CiteScore

4.80

自引率

7.70%

发文量

173

审稿时长

3 months

期刊介绍： The aim of Pharmacoepidemiology and Drug Safety is to provide an international forum for the communication and evaluation of data, methods and opinion in the discipline of pharmacoepidemiology. The Journal publishes peer-reviewed reports of original research, invited reviews and a variety of guest editorials and commentaries embracing scientific, medical, statistical, legal and economic aspects of pharmacoepidemiology and post-marketing surveillance of drug safety. Appropriate material in these categories may also be considered for publication as a Brief Report. Particular areas of interest include: design, analysis, results, and interpretation of studies looking at the benefit or safety of specific pharmaceuticals, biologics, or medical devices, including studies in pharmacovigilance, postmarketing surveillance, pharmacoeconomics, patient safety, molecular pharmacoepidemiology, or any other study within the broad field of pharmacoepidemiology; comparative effectiveness research relating to pharmaceuticals, biologics, and medical devices. Comparative effectiveness research is the generation and synthesis of evidence that compares the benefits and harms of alternative methods to prevent, diagnose, treat, and monitor a clinical condition, as these methods are truly used in the real world; methodologic contributions of relevance to pharmacoepidemiology, whether original contributions, reviews of existing methods, or tutorials for how to apply the methods of pharmacoepidemiology; assessments of harm versus benefit in drug therapy; patterns of drug utilization; relationships between pharmacoepidemiology and the formulation and interpretation of regulatory guidelines; evaluations of risk management plans and programmes relating to pharmaceuticals, biologics and medical devices.