Table 2. Cohort Characteristics of Women With Exposure to Stimulants During the First Trimester and Women Without Exposure to Any Stimulanta.
| Characteristic | Methylphenidate, No. (%) | Amphetamines, No. (%) | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Unadjusted | Adjustedb | Standardized Difference | Unadjusted | Adjustedb | Standardized Difference | |||||
| Methylphenidate | Unexposed | Methylphenidate | Unexposed | Amphetamines | Unexposed | Amphetamines | Unexposed | |||
| Total No. | 2072 | 1 797 938 | 2072 | 1 790 294 | NA | 5571 | 1 797 938 | 5570 | 1 781 473 | NA |
| Age, mean (SD), y | 21.9 (6.2) | 24.3 (5.8) | 21.9 (6.2) | 22.0 (6.1) | −0.02 | 23.9 (6.0) | 24.3 (5.8) | 23.9 (6.0) | 23.5 (6.0) | 0.06 |
| Race/ethnicity | ||||||||||
| White | 1492 (72.0) | 710 245 (39.5) | 1492 (72.0) | 1 319 148 (73.7) | −0.04 | 4635 (83.2) | 710 245 (39.5) | 4634 (83.2) | 1 509 496 (84.7) | −0.04 |
| Black | 331 (16.0) | 590 905 (32.9) | 331 (16.0) | 272 276 (15.2) | 0.02 | 409 (7.3) | 590 905 (32.9) | 409 (7.3) | 123 113 (6.9) | 0.02 |
| Hispanic | 72 (3.5) | 264 861 (14.7) | 72 (3.5) | 54 986 (3.1) | 0.02 | 142 (2.5) | 264 861 (14.7) | 142 (2.5) | 39 055 (2.2) | 0.02 |
| Other | 177 (8.5) | 231 927 (12.9) | 177 (8.5) | 143 884 (8.0) | 0.02 | 385 (6.9) | 231 927 (12.9) | 385 (6.9) | 109 810 (6.2) | 0.03 |
| Multiple gestation | 60 (2.9) | 62 380 (3.5) | 60 (2.9) | 53 800 (3.0) | −0.01 | 163 (2.9) | 62 380 (3.5) | 163 (2.9) | 51 027 (2.9) | 0 |
| Psychiatric and neurologic conditions | ||||||||||
| ADHD | 1089 (52.6) | 10 170 (0.6) | 1089 (52.6) | 918 557 (51.3) | 0.03 | 3145 (56.5) | 10 170 (0.6) | 3144 (56.4) | 983 577 (55.2) | 0.02 |
| Depression | 444 (21.4) | 89 873 (5.0) | 444 (21.4) | 413 404 (23.1) | −0.04 | 1109 (19.9) | 89 873 (5.0) | 1108 (19.9) | 393 803 (22.1) | −0.05 |
| Anxiety | 362 (17.5) | 65 228 (3.6) | 362 (17.5) | 328 150 (18.3) | −0.02 | 1129 (20.3) | 65 228 (3.6) | 1128 (20.3) | 370 387 (20.8) | −0.01 |
| Alcohol abuse or dependence | 20 (1.0) | 7550 (0.4) | 20 (1.0) | 20 579 (1.1) | −0.02 | 41 (0.7) | 7550 (0.4) | 41 (0.7) | 15 898 (0.9) | −0.02 |
| Drug abuse or dependence | 58 (2.8) | 17 901 (1.0) | 58 (2.8) | 51 687 (2.9) | −0.01 | 132 (2.4) | 17 901 (1.0) | 132 (2.4) | 51 241 (2.9) | −0.03 |
| Smoking | 135 (6.5) | 62 254 (3.5) | 135 (6.5) | 123 878 (6.9) | −0.02 | 595 (10.7) | 62 254 (3.5) | 595 (10.7) | 193 524 (10.9) | −0.01 |
| Chronic maternal illness | ||||||||||
| Diabetes | 40 (1.9) | 36 602 (2.0) | 40 (1.9) | 36 026 (2.0) | −0.01 | 101 (1.8) | 36 602 (2.0) | 101 (1.8) | 31 822 (1.8) | 0 |
| Hypertension | 51 (2.5) | 41 610 (2.3) | 51 (2.5) | 44 741 (2.5) | 0 | 187 (3.4) | 41 610 (2.3) | 187 (3.4) | 54 623 (3.1) | 0.02 |
| Psychotropic medications | ||||||||||
| Anticonvulsants | 302 (14.6) | 35 644 (2.0) | 302 (14.6) | 253 340 (14.2) | 0.01 | 833 (15.0) | 35 644 (2.0) | 833 (15.0) | 295 249 (16.6) | −0.04 |
| Antidepressants | 1033 (49.9) | 155 155 (8.6) | 1033 (49.9) | 919 848 (51.4) | −0.03 | 2537 (45.5) | 155 155 (8.6) | 2536 (45.5) | 882 546 (49.5) | −0.08 |
| Antipsychotics | 375 (18.1) | 22 661 (1.3) | 375 (18.1) | 301 514 (16.8) | 0.03 | 749 (13.4) | 22 661 (1.3) | 748 (13.4) | 285 283 (16.0) | −0.07 |
| Benzodiazepines | 336 (16.2) | 54 893 (3.1) | 336 (16.2) | 309 708 (17.3) | −0.03 | 1315 (23.6) | 54 893 (3.1) | 1314 (23.6) | 419 872 (23.6) | 0 |
| Other hypnotics | 245 (11.8) | 63 265 (3.5) | 245 (11.8) | 215 082 (12.0) | −0.01 | 678 (12.2) | 63 265 (3.5) | 678 (12.2) | 224 236 (12.6) | −0.01 |
| Other concomitant medication | ||||||||||
| Antidiabetics | 23 (1.1) | 15 556 (0.9) | 23 (1.1) | 19 752 (1.1) | 0 | 69 (1.2) | 15 556 (0.9) | 69 (1.2) | 22 229 (1.3) | 0 |
| Antihypertensives | 175 (8.4) | 46 949 (2.6) | 175 (8.4) | 143 925 (8.0) | 0.01 | 422 (7.6) | 46 949 (2.6) | 421 (7.6) | 120 704 (6.8) | 0.03 |
| Opioids | 655 (31.6) | 355 764 (19.8) | 655 (31.6) | 589 741 (32.9) | −0.03 | 2386 (42.8) | 355 764 (19.8) | 2385 (42.8) | 765 743 (43.0) | 0 |
| Suspected teratogensc | 332 (16.0) | 163 453 (9.0) | 332 (16.0) | 293 790 (16.4) | −0.01 | 929 (16.7) | 163 453 (9.1) | 929 (16.7) | 297 237 (16.7) | 0 |
| Markers of comorbidity, mean (SD) | ||||||||||
| No. of generic drugs | 3.8 (3.5) | 1.7 (2.4) | 3.8 (3.5) | 3.9 (3.5) | −0.03 | 3.9 (3.5) | 1.7 (2.4) | 3.9 (3.5) | 4.2 (3.6) | −0.06 |
| No. of diagnoses | 4.9 (4.1) | 2.7 (3.2) | 4.9 (4.1) | 5.1 (4.1) | −0.04 | 5.1 (4.3) | 2.7 (3.2) | 5.1 (4.3) | 5.4 (4.4) | −0.05 |
| No. of outpatient visits | 7.5 (9.9) | 2.9 (4.1) | 7.5 (9.9) | 7.6 (8.7) | 0 | 6.0 (7.3) | 2.9 (4.1) | 6.1 (7.3) | 6.9 (7.7) | −0.12 |
Abbreviations: ADHD, attention-deficit/hyperactivity disorder; NA, not applicable; PS, propensity score.
a
Data obtained from Medicaid Analytic eXtract, 2000-2013.
b
To account for PS, the untreated observations were weighted using the distribution of the treated among 50 PS strata. Observations from the nonoverlapping regions of the PS distributions were trimmed.
c
Suspected teratogens included fluconazole, methimazole, danazol, propylthiouracil, progestins, angiotensin-converting enzyme inhibitors, and corticosteroids. Women exposed to known teratogens (warfarin, antineoplastic agents, lithium, isotretinoin, misoprostol, thalidomide) were excluded from the cohort.