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儿童偏头痛与婴儿绞痛病史的相关性。

Association between childhood migraine and history of infantile colic.

机构信息

Department of Pediatric Emergency Care, APHP-Hospital Robert Debré, Paris, France.

出版信息

JAMA. 2013 Apr 17;309(15):1607-12. doi: 10.1001/jama.2013.747.

Abstract

IMPORTANCE

Infantile colic is a common cause of inconsolable crying during the first months of life and has been thought to be a pain syndrome. Migraine is a common cause of headache pain in childhood. Whether there is an association between these 2 types of pain in unknown.

OBJECTIVE

To investigate a possible association between infantile colic and migraines in childhood.

DESIGN, SETTING, AND PARTICIPANTS: A case-control study of 208 consecutive children aged 6 to 18 years presenting to the emergency department and diagnosed as having migraines in 3 European tertiary care hospitals between April 2012 and June 2012. The control group was composed of 471 children in the same age range who visited the emergency department of each participating center for minor trauma during the same period. A structured questionnaire identified personal history of infantile colic for case and control participants, confirmed by health booklets. A second study of 120 children diagnosed with tension-type headaches was done to test the specificity of the association.

MAIN OUTCOMES AND MEASURES

Difference in the prevalence of infantile colic between children with and without a diagnosis of migraine.

RESULTS

Children with migraine were more likely to have experienced infantile colic than those without migraine (72.6% vs 26.5%; odds ratio [OR], 6.61 [95% CI, 4.38-10.00]; P < .001), either migraine without aura (n = 142; 73.9% vs 26.5%; OR, 7.01 [95% CI, 4.43-11.09]; P < .001), or migraine with aura (n = 66; 69.7% vs 26.5%; OR, 5.73 [95% CI, 3.07-10.73]; P < .001). This association was not found for children with tension-type headache (35% vs 26.5%; OR, 1.46 [95% CI, 0.92-2.32]; P = .10).

CONCLUSION AND RELEVANCE

The presence of migraine in children and adolescents aged 6 to 18 years was associated with a history of infantile colic. Additional longitudinal studies are required.

摘要

重要性

婴儿肠绞痛是生命最初几个月中无法安慰的哭泣的常见原因,被认为是一种疼痛综合征。偏头痛是儿童头痛的常见原因。这两种类型的疼痛之间是否存在关联尚不清楚。

目的

调查儿童期婴儿肠绞痛和偏头痛之间可能存在的关联。

设计、地点和参与者:这是一项病例对照研究,纳入了 208 名连续就诊于欧洲 3 家三级保健医院急诊科的年龄在 6 至 18 岁之间的偏头痛患儿。对照组由同一时期在每个参与中心因轻微创伤就诊的 471 名年龄在相同范围内的儿童组成。通过结构化问卷确定病例组和对照组参与者的婴儿肠绞痛个人病史,并通过健康手册确认。对 120 名被诊断为紧张型头痛的儿童进行了第二项研究,以测试该关联的特异性。

主要结果和测量指标

患有偏头痛的儿童与未患偏头痛的儿童之间婴儿肠绞痛患病率的差异。

结果

与无偏头痛的儿童相比,患有偏头痛的儿童更有可能经历过婴儿肠绞痛(72.6% vs 26.5%;比值比[OR],6.61[95%置信区间,4.38-10.00];P<0.001),无论是无先兆偏头痛(n=142;73.9% vs 26.5%;OR,7.01[95%置信区间,4.43-11.09];P<0.001)还是有先兆偏头痛(n=66;69.7% vs 26.5%;OR,5.73[95%置信区间,3.07-10.73];P<0.001)。这种关联在患有紧张型头痛的儿童中并未发现(35% vs 26.5%;OR,1.46[95%置信区间,0.92-2.32];P=0.10)。

结论和相关性

6 至 18 岁儿童偏头痛的存在与婴儿肠绞痛病史相关。需要进一步进行纵向研究。

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