Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA 98195-7236, USA.
Paediatr Perinat Epidemiol. 2011 Mar;25(2):116-23. doi: 10.1111/j.1365-3016.2010.01182.x. Epub 2011 Jan 14.
We evaluated the risks of preterm delivery and hypertensive disorders of pregnancy among pregnant women with mood and migraine disorders, using a cohort study of 3432 pregnant women. Maternal pre-pregnancy or early pregnancy (<20 weeks gestation) mood disorder and pre-pregnancy migraine diagnoses were ascertained from interview and medical record review. We fitted generalised linear models to derive risk ratios (RR) and 95% confidence intervals (CI) of preterm delivery and hypertensive disorders of pregnancy for women with isolated mood, isolated migraine and co-morbid mood-migraine disorders, respectively. Reported RR were adjusted for maternal age, race/ethnicity, marital status, parity, smoking status, chronic hypertension or pre-existing diabetes mellitus, and pre-pregnancy body mass index. Women without mood or migraine disorders were defined as the reference group. The risks for preterm delivery and hypertensive disorders of pregnancy were more consistently elevated among women with co-morbid mood-migraine disorders than among women with isolated mood or migraine disorder. Women with co-morbid disorders were almost twice as likely to deliver preterm (adjusted RR=1.87, 95% CI 1.05, 3.34) compared with the reference group. There was no clear evidence of increased risks of preterm delivery and its subtypes with isolated migraine disorder. Women with mood disorder had elevated risks of pre-eclampsia (adjusted RR=3.57, 95% CI 1.83, 6.99). Our results suggest an association between isolated migraine disorder and pregnancy-induced hypertension (adjusted RR=1.42, 95% CI 1.00, 2.01). This is the first study examining perinatal outcomes in women with co-morbid mood-migraine disorders. Pregnant women with a history of migraine may benefit from screening for depression during prenatal care and vigilant monitoring, especially for women with co-morbid mood and migraine disorders.
我们通过一项包含 3432 名孕妇的队列研究，评估了患有心境和偏头痛障碍的孕妇发生早产和妊娠高血压疾病的风险。通过访谈和病历回顾确定孕妇在怀孕前或怀孕早期（<20 周妊娠）的心境障碍和孕前偏头痛诊断。我们使用广义线性模型得出分别患有孤立性心境障碍、孤立性偏头痛和共患心境-偏头痛障碍的孕妇早产和妊娠高血压疾病的风险比（RR）和 95%置信区间（CI）。报告的 RR 调整了母亲的年龄、种族/民族、婚姻状况、产次、吸烟状况、慢性高血压或既往糖尿病以及孕前体重指数。无心境或偏头痛障碍的女性被定义为参考组。与患有孤立性心境或偏头痛障碍的女性相比，患有共患心境-偏头痛障碍的女性早产和妊娠高血压疾病的风险更为一致地升高。患有共患疾病的女性早产的可能性几乎是参考组的两倍（调整 RR=1.87，95%CI 1.05，3.34）。孤立性偏头痛障碍与早产及其亚型的风险增加没有明显证据。患有心境障碍的女性患有子痫前期的风险增加（调整 RR=3.57，95%CI 1.83，6.99）。我们的研究结果表明，孤立性偏头痛障碍与妊娠引起的高血压之间存在关联（调整 RR=1.42，95%CI 1.00，2.01）。这是第一项研究共患心境-偏头痛障碍的孕妇围产期结局的研究。有偏头痛病史的孕妇在产前护理期间可能受益于抑郁症筛查和密切监测，尤其是对于共患心境和偏头痛障碍的女性。
