Grant: Project Grant

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental condition that affects attention, impulse control, planning, organization, emotional reactivity, and mood. It typically presents in childhood and is known to persist into adolescence and adulthood. ADHD diagnoses have been increasing in Canada over time, and there has also been a resulting increase the prescribing prevalence of ADHD medications (most commonly stimulant medications), particularly in adult women. Girls' ADHD symptoms have historically presented as disorganization, overwhelm or distraction, which were more likely to be ignored because of their apparent mildness. Parents were more likely to underreport ADHD symptoms in girls than in boys. Thus, the increase in diagnosis and medication use in adult women may represent a correction of this bias. However, this correction has also resulted in a sharp increase in fetal exposure to ADHD medication. Our preliminary data show an increase in use of ADHD medication during pregnancy from 0.4 per 1000 pregnancies in 2000 to 4.3 per 1000 pregnancies in 2021, representing an 11-fold increase. While current evidence on the safety of ADHD medication use in pregnancy is generally reassuring, there have been very few studies of long-term outcomes in children who were exposed to stimulants during pregnancy. Herein we propose to use rich population-based data in BC linked to the development data reported by the kindergarten teacher and development data self-reported by the child in Grade 4 to assess whether there are meaningful developmental differences between children with fetal exposure to ADHD and stimulant medication compared to those who were unexposed. This research will result in a better understanding of the long-term consequences of ADHD medication exposure in pregnancy which can be used to help pregnant people and their providers make decisions regarding their ADHD medication use during pregnancy.