ADHD medication methylphenidate during pregnancy not tied to malformation: Study

Denmark: The use of methylphenidate during pregnancy is not associated with an increased risk of malformations, finds a recent study in the Journal of Clinical Psychiatry. 

Attention-deficit/hyperactivity disorder (ADHD) medications are being used increasingly in pregnancy. Studies on the safety of these medications are based mostly on live births which may underestimate severe teratogenic effects that may cause termination of pregnancy or fetal demise. The study by Line Kolding, department of obstetrics and gynecology, Aarhus University Hospital, Denmark, and colleagues addresses this limitation by including data from both prenatal and postnatal diagnoses of major malformations.

For the purpose, the researchers performed a nationwide registry-based study of 364,012 singleton pregnancies in Denmark from November 1, 2007, to February 1, 2014. Using redeemed prescriptions from the Danish Health Services Prescription Database, exposures to ADHD medication were obtained. 

Outcome data included prenatally diagnosed malformations from the Danish Fetal Medicine Database and postnatally diagnosed malformations from the Danish National Patient Registry. The primary outcome was major malformations overall, and secondary outcomes were malformations of the central nervous system and cardiac malformations. The comparison group was pregnancies with no redeemed prescriptions for ADHD medication.