Obstetrics and gynecology
January 8, 2026 · via Europe PMC
Psychostimulant Continuation and Postpartum Mental Health in Pregnant People With Attention-Deficit/Hyperactivity Disorder.
Xu KY, Pappas LM, Brown TR, +8 more, Bruno AM.
AI summary — for doctors, generated from the abstract only
Among pregnant people with ADHD adherent to psychostimulants before pregnancy, continuing medication during pregnancy was not associated with worse postpartum mental health after adjustment for confounders.
What was studied
A retrospective cohort study of 3,676 pregnant individuals with ADHD and prior psychostimulant adherence in the MarketScan commercial claims database (2011-2021), comparing continuation with discontinuation.
Key findings
- 41.4% discontinued, 51.7% had <80% days covered, 7.0% had ≥80% days covered
- Postpartum mental health admissions 3.3%; new mood/anxiety diagnoses 16.2%
- Unadjusted higher mood/anxiety diagnoses with continuation (19.3% vs 12.8%) not significant after adjustment
- Adjusted RR for admissions 1.01 (0.59-1.71); new diagnoses 1.30 (0.97-1.74)
- Preexisting mental health diagnoses (RR 2.60) and comorbidities (RR 1.98) strongest predictors of admission
Clinical relevance
This supports shared decision-making that does not presume psychostimulant continuation worsens postpartum mental health, while noting the observational design.
Who should care
Limitations
Claims-based observational data with possible residual confounding by indication; commercially insured population.
Continuing ADHD stimulants in pregnancy did not appear to harm postpartum mental health.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Objective
To evaluate the association between psychostimulant continuation, compared with discontinuation, and postpartum mental health outcomes in pregnant people with attention-deficit/hyperactivity disorder (ADHD) who had consistent psychostimulant prescriptions before pregnancy.
Methods
This was a retrospective cohort study that used the Merative MarketScan Commercial Claims Database (2011-2021). Included individuals were aged 13-50 years with singleton pregnancies, had delivered at or after 20 weeks of gestation, and had an ADHD diagnosis and psychostimulant adherence. Psychostimulant use during pregnancy was classified as no refills, the proportion of days covered below 80%, or the proportion of days covered at or above 80%. The primary outcomes were mental health events that occurred within 1 year postpartum, such as emergency department or inpatient mental health-related admissions, and new diagnoses of mood or anxiety disorders. Adjusted event rate ratios were estimated using Poisson regression, controlling for maternal age, gestational age at delivery, maternal comorbidities, and preexisting mental health diagnoses.
Results
Among 3,676 eligible patients, 1,521 (41.4%) had no psychostimulant prescriptions during pregnancy (discontinued), 1,899 (51.7%) had a proportion of days covered below 80%, and 256 (7.0%) maintained a proportion of days covered at or above 80%. Overall, 3.3% (95% CI, 2.7-4.0%) experienced postpartum mental health-related admissions and 16.2% (95% CI, 14.6-18.0%) received new postpartum mood or anxiety disorder diagnoses. Although unadjusted analyses suggested a higher incidence of postpartum mood or anxiety disorders among patients continuing psychostimulants than those who discontinued (19.3% vs 12.8%; rate ratio 1.46, 95% CI, 1.17-1.83), this association was no longer observed after controlling for confounders. In adjusted analyses, continuation of psychostimulants during pregnancy was not associated with differences in postpartum mental health-related admissions (rate ratio 1.01, 95% CI, 0.59-1.71) or new mood or anxiety disorder diagnoses (rate ratio 1.30, 95% CI, 0.97-1.74). Preexisting mental health diagnoses (rate ratio 2.60, 95% CI, 1.76-3.90) and medical comorbidities (rate ratio 1.98, 95% CI, 1.33-2.93) were the strongest predictors of postpartum admissions.
Conclusion
Among individuals with ADHD adherent to psychostimulants before pregnancy, the continuation of medication during pregnancy was not associated with adverse postpartum mental health outcomes when compared with discontinuation of medication.
DOI
10.1097/aog.0000000000006169
PMID
41511017
PMCID
PMC12795318
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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