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

中文翻译：

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妊娠期和产后注意力缺陷/多动障碍

注意力缺陷/多动障碍是一种儿童期发病的神经发育障碍，经常持续到成年期，3% 的成年女性被诊断为注意力缺陷/多动障碍。许多妇女在育龄期接受诊断和治疗，这对怀孕和产后期的管理产生影响。我们从临床实践中知道，注意力缺陷/多动障碍症状在围产期常常变得难以管理，需要额外的支持和关注。医疗保健提供者对于围产期注意力缺陷/多动症的治疗常常存在不确定性，特别是药物治疗对发育中胎儿的安全性。本指南重点关注围产期注意力缺陷/多动症管理的最佳实践。我们建议（1）通过个体化治疗计划来减轻与注意力缺陷/多动障碍相关的风险，这些风险在围产期会恶化； (2) 提供心理教育、自我管理策略或辅导以及心理治疗；对于患有中度或重度注意力缺陷/多动障碍的患者，（3）考虑针对注意力缺陷/多动障碍的药物治疗，这在很大程度上具有令人放心的安全性数据。具体而言，医疗服务提供者应与患者及其支持网络合作，平衡围产期注意力缺陷/多动障碍药物治疗的风险与怀孕期间注意力缺陷/多动障碍治疗不当的风险。通过孕前咨询和适当的围产期规划、管理和支持，可以成功管理妊娠期注意力缺陷/多动障碍的风险和影响。