Department of Paediatric Emergency Care, DM'UP, APHP, Hôpital Robert Debré, 48 Boulevard Serrurier, Paris, 75019, France.
Child Neuropsychiatry Unit, ISMEP, ARNAS Civico, Palermo, Italy.
Eur J Pediatr. 2022 Apr;181(4):1679-1687. doi: 10.1007/s00431-021-04368-6. Epub 2022 Jan 10.
Infantile regurgitation is one of the most common discomforts in the first months of life. Infantile colic and, in older children, functional dyspepsia have been linked to migraine. To date, this is the first study to investigate a possible association between infantile regurgitation and primary headaches in children. This is a case-control study of 195 children aged 6-17 years, with primary headache (migraine, or tension type headache) in 5 European paediatric hospitals. The control group is composed of 240 same-aged children attending with minor injuries during the same period - February 1st 2020 to December 1st 2020. A structured questionnaire identified a history of infantile regurgitation and other functional gastrointestinal disorders for case and control participants. The outcome was the difference in the prevalence of infantile regurgitation among children with or without a diagnosis of primary headache. The analysis showed a significant association between infantile regurgitation and migraine (OR = 1.88, CI 95 = 1.01-3.4, p = 0.04). No association was found between infantile regurgitation and tension type headache (p = 0.33). Subgroup analysis confirmed that the association was only significant for migraine without aura (OR = 2.3, CI 95 = 1.2-4.4, p = 0.01). In a further subgroup analysis, the presence of functional dyspepsia, irritable bowel syndrome and abdominal migraine was associated with migraine without aura.
The presence of migraine among children aged 6-17 was associated with a history of infantile regurgitation. Additional longitudinal studies are required to confirm whether infantile regurgitation could be considered as a precursor of migraine.
• Children suffering from functional gastrointestinal disorders are more likely to be suffering from migraine and tension-type headache as well. • Children suffering from primary headache are more likely to have had infantile colic in their first six month of life.
• It is the first study to find an association between migraine and infantile regurgitation in children. • These findings could have an impact on the diagnosis and therapeutics of both migraine and infantile regurgitation.
目的：婴幼儿反流是生命最初几个月最常见的不适之一。婴幼儿绞痛，以及年龄较大的儿童功能性消化不良，都与偏头痛有关。迄今为止，这是第一项研究婴幼儿反流与儿童原发性头痛之间可能存在关联的研究。这是一项病例对照研究，纳入了欧洲 5 家儿科医院的 195 名 6-17 岁的原发性头痛（偏头痛或紧张型头痛）患儿。对照组由同期（2020 年 2 月 1 日至 2020 年 12 月 1 日）因轻微外伤就诊的 240 名同龄儿童组成。结构化问卷识别了病例和对照组参与者的婴幼儿反流和其他功能性胃肠疾病史。结果为有或无原发性头痛诊断的儿童中婴幼儿反流的患病率差异。分析显示婴幼儿反流与偏头痛之间存在显著关联（OR=1.88，95%CI 95=1.01-3.4，p=0.04）。婴幼儿反流与紧张型头痛之间无关联（p=0.33）。亚组分析证实，这种关联仅在无先兆偏头痛中具有统计学意义（OR=2.3，95%CI 95=1.2-4.4，p=0.01）。在进一步的亚组分析中，功能性消化不良、肠易激综合征和腹型偏头痛的存在与无先兆偏头痛相关。
结论：6-17 岁儿童偏头痛的存在与婴幼儿反流史相关。需要进一步的纵向研究来确认婴幼儿反流是否可被视为偏头痛的前兆。
已知内容：患有功能性胃肠疾病的儿童更有可能患有偏头痛和紧张型头痛。患有原发性头痛的儿童在其生命的头 6 个月更有可能患婴儿绞痛。
新内容：这是第一项研究婴幼儿反流与儿童偏头痛之间关联的研究。这些发现可能会对偏头痛和婴幼儿反流的诊断和治疗产生影响。
