(1007) Practice attitudes and behaviors for peripartum management of attention deficit hyperactivity disorder (ADHD).

Friday, January 31, 2025

4:00 PM – 6:00 PM

Submitting Author(s)

Cresta W. Jones, MD (she/her/hers)

Associate Professor
University of Minnesota Medical School
Minneapolis, Minnesota, United States

Presenting Author(s)

Bukky Akingbola, DO, MS (she/her/hers)

Resident Physician
University of Minnesota
Minneapolis, Minnesota, United States

Coauthor(s)

JM

Jessica Makori, BS

University of Minnesota
Minneapolis, Minnesota, United States
Anwei Gwan, MS, MD, MPH

Resident
University of Minnesota
Minneapolis, Minnesota, United States
CD

Connor Demorest, BS, MS

Biostatistician
Masonic Cancer Center, University of Minesota
University of Minnesota/Minneapolis, Minnesota, United States
KT

Katelyn M. Tessier, BS, MS

Senior Biostatistician
University of Minnesota
Minneapolis, Minnesota, United States

Objective: There is no current standard of care for managing attention deficit hyperactivity disorder (ADHD) in pregnancy. This study explores current practice in peripartum ADHD management among healthcare providers within a single academic health system.

Study Design: Prospective Observational - Over a 6 month period (December of 2023 to June of 2024), a 17-item electronic survey was administered to 198 active women’s healthcare professionals within a single academic health system.

Results:
A total of 75 respondents completed the survey (37.8% response rate). The average years in practice was 13.4 years, and most respondents (95%) had directly cared for a peripartum patient with ADHD. The majority of respondents (78.7%) were unsure if ADHD medications could be safely used during pregnancy/peripartum period. With regards to medication dose prior to attempting pregnancy, most (60%) recommend decreasing to the lowest effective dose, 14.7% recommend no change in medication and 5.3% recommend stopping ADHD medications prior to conception. During pregnancy, 62.7% advised patients to decrease to the lowest effective dose, 17.3% advised patients to discontinue ADHD medications, and only 12% advised patients to stay on their pre-pregnancy medication dose. For patients continuing ADHD medications during pregnancy, 89.3% of providers recommend changes in obstetric care, including a detailed anatomic survey (62.7%),fetal growth ultrasound surveillance (57.5%), and/or third trimester antepartum surveillance (8%). In the postpartum period, there were significant variations in recommendations for medication treatment while breast/chest feeding.

Conclusion: There is significant variability among healthcare providers’ recommendations in the management of perinatal ADHD. We call for a need to align provider behaviors through the development of evidence-based perinatal ADHD guidelines.