Does Adderall Cause Autism in Newborns?
No, Adderall (amphetamine/dextroamphetamine) does not cause autism in newborns. There is no evidence linking amphetamine exposure during pregnancy to autism spectrum disorder in offspring 1, 2.
What the Evidence Shows About Amphetamines and Pregnancy Outcomes
The American College of Obstetricians and Gynecologists has clearly stated that amphetamines do not appear to be associated with major congenital malformations, including cardiac malformations, or other significant adverse developmental outcomes 2. Importantly, a large, well-controlled study demonstrated no increased risks for neurodevelopmental outcomes, including autism, when examining methylphenidate, amphetamine, dexamphetamine, lisdexamfetamine, modafinil, atomoxetine, or clonidine during pregnancy 1.
Actual Risks Associated with Amphetamine Use in Pregnancy
While autism is not a concern, there are some small risks to be aware of:
Structural malformations (very small absolute risk):
- Possible small increased risk for gastroschisis (adjusted OR 3.0,95% CI 1.2-7.4), though the absolute risk remains extremely small given gastroschisis affects only 0.05% of the population 2
- No increased risk for cardiac malformations specifically with amphetamines 2
Pregnancy complications:
- Possible small increased risk for preeclampsia (adjusted RR 1.29,95% CI 1.11-1.49), though this has not been consistently found across studies 2
- Potential small increased risk for preterm birth when stimulant use continues in the second half of pregnancy (adjusted RR 1.30,95% CI 1.10-1.55) 2
Risks of Untreated ADHD During Pregnancy
Discontinuing Adderall during pregnancy carries its own risks that must be weighed against medication risks:
- Untreated ADHD has been associated with increased risks for spontaneous abortion and preterm birth 2
- Stopping psychostimulant treatment during pregnancy can lead to worse maternal mental health outcomes and significant impairments in functioning 2
Clinical Approach to Adderall Use in Pregnancy
When a pregnant woman is taking Adderall, the decision should prioritize maternal functioning and fetal safety:
- Continue Adderall if the mother requires it for adequate functioning, as the developmental risks (including autism) are not supported by evidence 1, 2
- Monitor blood pressure and pulse regularly, as stimulants can increase these parameters 2
- Watch for signs of preeclampsia and preterm labor if continuing medication 2
- Maximum recommended dose remains 50 mg daily if continuing treatment 2
If medication is discontinued:
- Consider non-pharmacological approaches such as Dialectical Behavior Therapy (DBT) modified for adults with ADHD 2
- Consider non-stimulant alternatives like bupropion if medication is still needed 2
Common Pitfall to Avoid
The most significant pitfall is discontinuing necessary ADHD medication based on unfounded fears about autism or other neurodevelopmental outcomes. The evidence does not support these concerns, and stopping medication may cause more harm to both mother and baby through worsening maternal mental health, impaired functioning, and the known risks of untreated ADHD 1, 2.