What happens to the fetus when a pregnant woman takes a stimulant for AD/HD (Attention Deficit/Hyperactivity Disorder)?
Specifically, does that increase the risk of the baby developing a neurodevelopmental disorder such as Autism Spectrum Disorder, AD/HD, or others during childhood?
A research study by Suarez E. and colleagues on this topic was published in the journal JAMA Psychiatry online January 24, 2024.
They studied the offspring of 1,123 pregnant women who had taken a stimulant for AD/HD during the second half of pregnancy.
The researchers wanted to find out if the children had a higher rate of neurodevelopment disorders than children without that exposure.
The stimulants that the pregnant women took were either amphetamine/dextroamphetamine (common brand name is Adderall XR) or methylphenidate (common brand names are Ritalin and Concerta).
The bottom line is that there was NO EVIDENCE OF AN INCREASED RATE OF NEURODEVELOPMENTAL DISORDERS in these children.
This is good news that should reduce concerns that pregnant women may have about this issue.
Some “pro-life” advocates believe that abortion is always wrong, but others make exceptions to save the life of the mother or for other reasons.
“Pro-choice” advocates don’t want the government (state or federal) to tell women whether and when they can seek an abortion.
These are contentious issues, and both sides believe they are right.
According to the Gallup organization (polling organization) of adults polled “… 61% currently say that overturning Roe v. Wade was a ‘bad thing,’ while 38% call it a ‘good thing’.” [July 7, 2023 published in 2024]
The Gallup organization also reported in May 2023 that, of those polled, “34% believe abortion should be legal ‘under any circumstances,’ 51% say it should be legal ‘only under certain circumstances,’ and 13% say it should be illegal in all circumstances’.”
If these data are accurate and representative, a majority of people believe that abortion should be legal in all or at least some circumstances.
Those people who want abortion to be illegal on moral grounds do so presumably because they believe the life of the developing fetus is sacred.
But what do they think about society’s responsibilities once a baby is born? Being consistent requires “pro-life”advocates to be champions of assuring proper care of children from the moment they are born.
When comparing states that severely limit abortions to those that are more “pro-choice,” it appears that anti-abortion states do not provide the same level of services for children than pro-choice states.
For example, according to the Associated Press, “Social programs are weak in many states with tough abortion laws” (April 7, 2022).
The New York Times on July 28, 2022 reported: “States with abortion bans are among least supportive for mothers and children.”
National Public Radio noted that “States with the toughest abortion laws have the weakest maternal supports, data shows” (August 18, 2022).
If these reports are correct, those who want to limit abortion should do a lot more to show that the life of a baby after birth is at least as important to them as the life of an unborn fetus.
My opinion about the importance of caring for the needs of live children is independent of my thoughts about abortion. I may address that another time.
I prefer to stay up late and sleep in (when I can). I am a “night owl.”
That is at least partly because I have adult ADHD. Although being a night owl is not an official part of the diagnostic criteria for ADHD, people with this disorder tend to be night owls.
I have not been a teenager for a very long time, but my being a night owl is something I share with them. The internal rhythm in teens usually involves staying up late and being sleepy in the early AM.
That is why it is a challenge for teens to adhere to the standard school start time. Ideally, teens would start school later in the morning.
There are two practical problems with doing this. The first is that the school day would end later so there would be less time for after school activities.
The second problem is that the same school buses pick up all 3 age groups of kids, one group at a time. The high school kids are picked up first as it is safer for them to be out waiting for the bus when it may still be dark.
Then, the middle school kids are picked up, followed by grade school kids. In short, the same buses go the same route 3 times each school day. At least, that is what I have heard.
There does not appear to be an easy solution to this problem so teens (high school age) end up getting up early to get on a school bus Alas, that is not optimal for them based on their internal rhythm (circadian rhythm).
The American Academy of Pediatrics (AAP) has had a statement supporting affirmative treatment of children and teens with gender dysphoria. This may include psychotherapy, puberty blockers, cross-gender hormones, and surgery (some or all of these treatments).
Recently, their leadership reaffirmed their position on treatment. However, I was surprised to learn that they are engaging an outside research organization to review existing studies on this topic.
Why? I have not found a clear answer, so I am curious.
One potential explanation is that they are hoping that a neutral third party would be able to either solidify their position or find evidence that their position should be modified. This would make sense in light of controversy about this topic.
Another possibility is that they are not as confident in their current position as they would like to be. This may be, at least partly, because Sweden has reviewed studies on transgender care for children and have concluded that existing research is inconclusive.
That, too, raises my curiosity. What research is Sweden aware of that our AAP is not aware of or does not agree with? This is interesting because Sweden is not the only country reconsidering current treatments.
Sweden was an early adopter of medical management of transgender children. So, it may be surprising that they now think that there is insufficient evidence to confidently support current practice.
From what I can gather, it may be related to a desire to have longer term data on the effects of treatment. There is evidence of short term benefit, but I gather that there is controversy about whether the benefits persist and whether there are potential unknown long term harms.
Perhaps, these questions are why the AAP is seeking outside experts to review research findings. I trust that my curiosity will be settled once the review is completed.
What is the relative contribution of genetics vs the environment in children from birth to age two? A study by Austerberry and colleagues addressed this question in JAMA Network Open on August 22, 2022. They combined results from 21 countries in 6 continents of 31,053 identical twins (genes all the same) and 47,991 fraternal twins (genes are different just as any two non-twin siblings).
They also compared these twins raised in the same home vs twins raised apart. The researchers looked for similarities and differences in psychological traits and developmental milestones among these infants.
By comparing identical twins to fraternal twins, they found that “complex traits are substantially but not entirely” genetic. These complex traits were mainly “psychiatric, metabolic, and cognitive traits.”
Genetics were most notable for psychomotor functions, then attention functions, complex interpersonal interactions, family relationships, and emotional functions.
Twins growing up in the same home were compared to twins raised apart. These demonstrate the importance of the environment, and its interaction with genetics.
The overall result of these studies was “evidence that most domains of functioning, disability, and health in psychological and developmental milestones were heritable in infancy.” This was reinforced by comparing twins reared together vs apart.
All categories studied showed high degrees of heritability except for sleep and language functions. These last two had a strong environmental impact so that genetics played a lesser role than other types of functioning.
The authors wrote that these results “may improve public perception on nature and nurture, for example, dispelling widely held beliefs that infants are shaped entirely by their environment or that family history entirely predetermine child health, beliefs that may place undue pressure on parents.”
Health and Culture 