Gelaye Bizu, Do Ngan, Avila Samantha, Carlos Velez Juan, Zhong Qiu-Yue, Sanchez Sixto E, Peterlin B Lee, Williams Michelle A
Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
Asociación Chilena De Seguridad, Hospital del Trabajador, Santiago, Chile.
Headache. 2016 Jun;56(6):976-86. doi: 10.1111/head.12855. Epub 2016 May 31.
To examine the independent and joint associations of childhood abuse and intimate partner violence with migraine among pregnant women.
Childhood abuse and intimate partner violence have each been associated with migraine headaches in previous studies, but these associations have not been explored among pregnant women.
A cross-sectional study was conducted among a cohort of 2970 pregnant women attending prenatal clinics in Lima, Peru. History of childhood abuse (ie, physical or sexual abuse) was assessed using the Childhood Physical and Sexual Abuse Questionnaire. Intimate partner violence (IPV) was assessed using the World Health Organization questionnaire. Migraine classification (including migraine and probable migraine) was based on International Classification of Headache Disorders (ICHD)-III beta criteria. Multivariable logistic regression analyses were performed to estimate odd ratios (OR) and 95% confidence intervals (95% CI).
The prevalence of any migraine was 33.5% while approximately 70% of participants reported a history of childhood abuse and 36.7% a history of IPV. Women with a history of any childhood abuse had a 38% increased odds of any migraine compared to women with no history of childhood abuse (OR = 1.38; 95% CI 1.15-1.64). The odds of migraine increased with increasing numbers of experienced childhood abuse events (Ptrend < .001). Additionally, after adjusting for confounders women with a history of IPV had a 43% increased odds of any migraine as compared to women without intimate partner violence (OR = 1.43; 95%CI 1.02-2.02). Women with a joint positive history of childhood abuse and IPV, as compared with the reference group, had a 88% increased odds of migraine (aOR = 1.88, 95%CI: 1.51-2.35).
Childhood abuse and IPV are associated with increased odds of migraine in pregnant women. Our findings highlight the importance of screening for abuse among pregnant migraineurs to help guide treatment strategies.
探讨童年期虐待和亲密伴侣暴力与孕妇偏头痛之间的独立关联和联合关联。
在以往研究中，童年期虐待和亲密伴侣暴力均与偏头痛有关，但这些关联在孕妇中尚未得到探讨。
对秘鲁利马产前诊所的2970名孕妇队列进行了一项横断面研究。使用儿童身体和性虐待问卷评估童年期虐待史（即身体虐待或性虐待）。使用世界卫生组织问卷评估亲密伴侣暴力（IPV）。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（ICHD）-III beta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）。
任何偏头痛的患病率为33.5%，而约70%的参与者报告有童年期虐待史，36.7%有亲密伴侣暴力史。有任何童年期虐待史的女性患任何偏头痛的几率比无童年期虐待史的女性高38%（OR = 1.38；95%CI 1.15 - 1.64）。偏头痛的几率随着经历的童年期虐待事件数量的增加而增加（P趋势 <.001）。此外，在调整混杂因素后，有亲密伴侣暴力史的女性患任何偏头痛的几率比没有亲密伴侣暴力的女性高43%（OR = 1.43；95%CI 1.02 - 2.02）。与参照组相比，有童年期虐待和亲密伴侣暴力联合阳性史的女性患偏头痛的几率高88%（调整后OR = 1.88，95%CI：1.51 - 2.35）。
童年期虐待和亲密伴侣暴力与孕妇偏头痛几率增加有关。我们的研究结果强调了对患有偏头痛的孕妇进行虐待筛查以帮助指导治疗策略的重要性。
