Friedman Lauren E, Gelaye Bizu, Rondon Marta B, Sanchez Sixto E, Peterlin B Lee, Williams Michelle A
Harvard T. H. Chan School of Public Health - Epidemiology, Boston, MA, USA.
Cayetano Heredia Peruvian University - Department of Medicine, Lima, Peru.
Headache. 2016 Apr;56(4):741-9. doi: 10.1111/head.12793. Epub 2016 Mar 26.
Suicide is a leading cause of maternal death globally, and suicide prevalence rates have been shown to be increased in those with migraine. No previous study has examined the association between migraine and suicidal ideation during pregnancy.
To examine the association between migraine and suicidal ideation among a cohort of pregnant women.
A cross-sectional study was conducted among 3372 pregnant women attending prenatal care clinics in Lima, Peru. Suicidal ideation and depression were assessed using the Patient Health Questionnaire-9 (PHQ-9) scale during early pregnancy. Migraine classification (including migraine and probable migraine) was based on International Classification of Headache Disorders-III beta criteria. Multivariable logistic regression analyses were performed to estimate odds ratios (OR) and 95% confidence intervals (95% CI).
Suicidal ideation was more common among those with migraine (25.6%) as compared to those with probable migraine (22.1%, P < .001) or non-migraineurs (12.3%, P < .001). After adjusting for confounders, including depression, those with migraine or probable migraine had a 78% increased odds of suicidal ideation (OR = 1.78; 95% CI: 1.46-2.17), as compared with non-migraineurs. Women with both migraine and depression had a 4.14-fold increased odds of suicidal ideation (OR = 4.14; 95% CI: 3.17-5.42) compared to those with neither condition.
Migraine is associated with increased odds of suicidal ideation in pregnant women even when controlling for depression. These findings support the consideration of screening women with comorbid migraine and depression for suicidal behavior during pregnancy.
自杀是全球孕产妇死亡的主要原因之一，且偏头痛患者的自杀患病率已显示有所上升。此前尚无研究探讨孕期偏头痛与自杀意念之间的关联。
研究一组孕妇中偏头痛与自杀意念之间的关联。
对秘鲁利马产前保健诊所的3372名孕妇进行了一项横断面研究。在孕早期使用患者健康问卷-9（PHQ-9）量表评估自杀意念和抑郁情况。偏头痛分类（包括偏头痛和可能的偏头痛）基于《国际头痛疾病分类第三版β标准》。进行多变量逻辑回归分析以估计比值比（OR）和95%置信区间（95%CI）。
与可能患有偏头痛的患者（22.1%，P <.001）或无偏头痛的患者（12.3%，P <.001）相比，偏头痛患者的自杀意念更为常见（25.6%）。在对包括抑郁在内的混杂因素进行调整后，与无偏头痛的患者相比，患有偏头痛或可能患有偏头痛的患者出现自杀意念的几率增加了78%（OR = 1.78；95%CI：1.46 - 2.17）。与既无偏头痛也无抑郁的女性相比，同时患有偏头痛和抑郁的女性出现自杀意念的几率增加了4.14倍（OR = 4.14；95%CI：3.17 - 5.42）。
即使在控制抑郁的情况下，偏头痛也与孕妇自杀意念几率的增加有关。这些发现支持在孕期对合并偏头痛和抑郁的女性进行自杀行为筛查。
