Differences in perinatal experiences in females with and without ADHD: a cross-sectional study considering diagnostic status and traits

Background Attention deficit/hyperactivity disorder (ADHD) may be impacted by sex hormones but there is little research investigating the experiences of ADHD at times of known hormonal change such as pregnancy. The current study aimed to better understand how females with ADHD experience antenatal care, pregnancy and breastfeeding. Methods Females in the perinatal period reporting a diagnosis of ADHD ( N = 198) were compared to those without a diagnosis ( N = 152) using an online survey assessing pregnancy worries, breastfeeding experience and satisfaction with antenatal care alongside indicators of attendance of antenatal care appointments in the first trimester and across the entire pregnancy. Regression analyses compared the two groups with additional exploratory analyses comparing those with ADHD on and off medication during periods of pregnancy and breastfeeding. Trait-based comparisons were also made to test whether ADHD-traits, independent of diagnosis, were associated with these factors. Results Having an ADHD diagnosis was associated with greater pregnancy worries ( p <.001) and poorer experiences of the lifestyle dimension of breastfeeding ( p =.020) compared to those without a diagnosis. ADHD traits were associated with worries independently of diagnosis ( p <.001, p <.002, respectively) whilst only traits were associated with breastfeeding lifestyle ( p =.006). There were no group differences or traits relationships for antenatal care service satisfaction ( p >.05) whilst ceiling effects on attendance prevented meaningful analysis. Exploratory analysis indicated no effects of medication on pregnancy worries or service satisfaction ( p >.05) whilst medication during breastfeeding may improve lifestyle aspects ( p =.046), but caution is needed due to the small sample. Discussion Pregnancy worries were higher in those with concurrent health conditions and ADHD whilst experiences of breastfeeding were generally associated with fewer worries. Breastfeeding experiences related to infant satisfaction and maternal enjoyment were associated only with specific pregnancy and breastfeeding experiences and not related to ADHD diagnosis or traits. However, the experiences related to the emotional and physical toll of breastfeeding and sense of their own body did differ with worse experiences for those with ADHD or high ADHD traits. Service satisfaction appeared unrelated to ADHD diagnosis or traits. Attendance at appointments was consistently high preventing meaningful analysis. No effects of medication were found during pregnancy in the exploratory analyses, although medication during breastfeeding was associated with slightly better experiences but the sample size was small, limiting the conclusions that can be drawn. Conclusion These findings indicate that females with ADHD may have different perinatal experiences to those without ADHD with greater pregnancy worries and poorer experiences of some aspects of breastfeeding associated with both ADHD diagnosis and ADHD traits.