التفاصيل البيبلوغرافية
| العنوان: |
Pre-pregnancy migraine diagnosis, medication use, and spontaneous abortion: a prospective cohort study. |
| المؤلفون: |
Crowe, Holly M.1,2 hcrowe@hsph.harvard.edu, Wesselink, Amelia K.2, Wise, Lauren A.2, Jick, Susan S.2, Rothman, Kenneth J.2, Mikkelsen, Ellen M.3, Sørensen, Henrik T.3, Hatch, Elizabeth E.2 |
| المصدر: |
Journal of Headache & Pain. 12/20/2022, Vol. 23 Issue 1, p1-11. 11p. |
| مصطلحات موضوعية: |
*MIGRAINE prevention, *MIGRAINE diagnosis, *PATIENT aftercare, *CONFIDENCE intervals, *MIGRAINE, *ANALGESICS, *REGRESSION analysis, *SEVERITY of illness index, *QUESTIONNAIRES, *DRUGS, *CAFFEINE, *DRUG utilization, *MEDICAL prescriptions, *PRECONCEPTION care, *REPRODUCTIVE health, *PROPORTIONAL hazards models, RISK factors in miscarriages |
| مصطلحات جغرافية: |
UNITED States, CANADA |
| مستخلص: |
Background: Migraine is common among females of reproductive age (estimated prevalence:17–24%) and may be associated with reproductive health through underlying central nervous system excitability, autoimmune conditions, and autonomic dysfunction. We evaluated the extent to which pre-pregnancy migraine diagnosis and medication use are associated with risk of spontaneous abortion (SAB). Methods: We analyzed data from a preconception study of pregnancy planners (2013–2021). Eligible participants self-identified as female, were aged 21–45 years, resided in the USA or Canada, and conceived during follow-up (n = 7890). Participants completed baseline and bimonthly follow-up questionnaires for up to 12 months or until a reported pregnancy, whichever occurred first. Pregnant participants then completed questionnaires during early (~ 8–9 weeks) and late (~ 32 weeks) gestation. We defined migraineurs as participants who reported a migraine diagnosis or use of a medication to treat migraine. Preconception questionnaires elicited migraine medication use during the past 4 weeks, and SAB on follow-up and pregnancy questionnaires. We used Cox regression models with gestational weeks as the time scale to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for associations among preconception migraine, migraine medication use, and SAB, controlling for potential demographic, medical, and lifestyle confounders. Results: Nineteen percent of study pregnancies ended in SAB. History of migraine before conception was not appreciably associated with SAB risk (HR = 1.03, 95% CI: 0.91–1.06). Use of any migraine medication was associated with a modest increase in SAB risk overall (HR = 1.14, 95% CI: 0.96–1.36). We observed the greatest increase in risk among those taking migraine medications daily (HR = 1.38, 95% CI: 0.81–2.35) and those taking prescription migraine prophylaxis (HR = 1.43, 95% CI: 0.72–2.84) or combination analgesic and caffeine medications (HR = 1.42, 95% CI: 0.99–2.04). Conclusions: Migraine medication use patterns suggesting greater underlying migraine severity were associated with increased risk of SAB. This research adds to the limited information available on the reproductive effects of migraine. [ABSTRACT FROM AUTHOR] |
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