Friedman Lauren E, Aponte Christina, Perez Hernandez Rigoberto, Velez Juan Carlos, Gelaye Bizu, Sánchez Sixto E, Williams Michelle A, Peterlin B Lee
Department of Epidemiology, Harvard T. H. Chan School of Public Health, 677 Huntington Ave, K501, Boston, MA, 02115, USA.
Multidisciplinary International Research Training Program, Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
J Headache Pain. 2017 Dec;18(1):67. doi: 10.1186/s10194-017-0775-5. Epub 2017 Jul 6.
Individually both migraine and post-traumatic stress disorder (PTSD) prevalence estimates are higher among women. However, there is limited data on the association of migraine and PTSD in women during pregnancy.
We examined the association between migraine and PTSD among women attending prenatal clinics in Peru. Migraine was characterized using the International Classification of Headache Disorders (ICHD)-III beta criteria. PTSD was assessed using the PTSD Checklist-Civilian Version (PCL-C). Multivariable logistic regression analyses were performed to estimate odds ratios (OR) and 95% confidence intervals (CI) after adjusting for confounders.
Of the 2922 pregnant women included, 33.5% fulfilled criteria for any migraine (migraine 12.5%; probable migraine 21.0%) and 37.4% fulfilled PTSD criteria. Even when controlling for depression, women with any migraine had almost a 2-fold increased odds of PTSD (OR: 1.97; 95% CI: 1.64-2.37) as compared to women without migraine. Specifically, women with migraine alone (i.e. excluding probable migraine) had a 2.85-fold increased odds of PTSD (95% CI: 2.18-3.74), and women with probable migraine alone had a 1.61-fold increased odds of PTSD (95% CI: 1.30-1.99) as compared to those without migraine, even after controlling for depression. In those women with both migraine and comorbid depression, the odds of PTSD in all migraine categories were even further increased as compared to those women without migraine.
In a cohort of pregnant women, irrespective of the presence or absence of depression, the odds of PTSD is increased in those with migraine. Our findings suggest the importance of screening for PTSD, specifically in pregnant women with migraine.
偏头痛和创伤后应激障碍（PTSD）的患病率估计在女性中均较高。然而，关于孕期女性偏头痛与PTSD之间关联的数据有限。
我们研究了秘鲁产前诊所就诊女性中偏头痛与PTSD之间的关联。偏头痛采用《国际头痛疾病分类》（ICHD）-III beta标准进行界定。PTSD使用《PTSD检查表-平民版》（PCL-C）进行评估。在对混杂因素进行调整后，进行多变量逻辑回归分析以估计优势比（OR）和95%置信区间（CI）。
在纳入的2922名孕妇中，33.5%符合任何偏头痛标准（偏头痛12.5%；可能偏头痛21.0%），37.4%符合PTSD标准。即使在控制了抑郁症因素后，与无偏头痛的女性相比，患有任何偏头痛的女性患PTSD的几率几乎增加了两倍（OR：1.97；95%CI：1.64 - 2.37）。具体而言，仅患有偏头痛（即不包括可能偏头痛）的女性患PTSD的几率增加了2.85倍（95%CI：2.18 - 3.74），仅患有可能偏头痛的女性患PTSD的几率增加了1.61倍（95%CI：1.30 - 1.99），与无偏头痛的女性相比，即使在控制了抑郁症因素后也是如此。在同时患有偏头痛和合并抑郁症的女性中，与无偏头痛的女性相比，所有偏头痛类型中PTSD的几率进一步增加。
在一组孕妇中，无论是否存在抑郁症，患有偏头痛的女性患PTSD的几率都会增加。我们的研究结果表明筛查PTSD的重要性，特别是对于患有偏头痛的孕妇。
