Attention-Deficit / Hyperactivity Disorder in pregnancy and the postpartum period.

Attention-deficit/hyperactivity disorder (ADHD) is a childhood-onset neurodevelopmental disorder that frequently persists into adulthood, with 3% of adult women having a diagnosis of ADHD. Many women are diagnosed and treated during their reproductive years, resulting in management implications across pregnancy and postpartum. We know from clinical practice that ADHD symptoms frequently become challenging to manage during the perinatal period, requiring additional support and attention. There is often uncertainty among healthcare providers regarding the management of ADHD in the perinatal period, particularly the safety of pharmacotherapy for the developing fetus. This guideline is focused on best practices in managing ADHD in the perinatal period. We recommend: 1) mitigation of risks associated with ADHD worsening during the perinatal period via individualized treatment planning; 2) delivery of psychoeducation, self-management strategies/coaching, and psychotherapies; and, for those with moderate/severe ADHD, 3) consideration of ADHD pharmacotherapy, which has largely reassuring safety data. Specifically, providers should work collaboratively with patients and their support networks to balance the risks of perinatal ADHD medication with the risks of inadequately treated ADHD in pregnancy. The risks and impacts of ADHD in pregnancy can be successfully managed through preconception counselling and appropriate perinatal planning, management, and support.