Depression, anxiety and stress among pregnant migraineurs in a pacific-northwest cohort

Abstract

Background The co-occurrence of migraine and unipolar psychiatric disorders has been well documented in non-pregnant populations, however little is known in pregnant populations. Methods A cohort of 1,321 women was interviewed during the first trimester of pregnancy. At the time of interview lifetime migraine status was ascertained using International Classification of Headache Disorders diagnostic criteria (ICHD-II). Information regarding unipolar depression, anxiety and stress during pregnancy was collected using the Patient Health Questionnaire Depression Module-9 (PHQ-9), and the Depression Anxiety Stress Scales 21-item Short Form (DASS-21). Multivariable logistic regression procedures were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association of migraine and mood disorders during pregnancy. Results Approximately 28.2% (N=372) were classified as having a lifetime history of migraine; among migraineurs 122 were classified as migraineurs with aura and 250 as migraineurs without aura. Compared with non-migraineurs, migraineurs were associated with 1.60-fold increased odds of depression as measured by a PHQ-9 score ≥10 (AOR=1.60; 95% CI: 1.12–2.31). Overall, migraine with aura was more strongly associated with depression than was migraine without aura. Migraineurs, as compared with non-migraineurs, also had higher odds of mood disorders as measured by the DASS-21. Conclusions The comorbidity of mood and migraine disorders in pregnant populations supports the need for integrated mental and physical clinical evaluation, increased vigilance, and treatment of patients with such disorders.

Sociodemographic, obstetric characteristics, antenatal morbidities, and perinatal depressive symptoms: A three-wave prospective study

“…This study showed that headache was a significant factor of antenatal depressive symptoms, which is consistent with a previous study [ 25 ]. One possibility for this observation is that Chinese people tend to somatize their depressive symptoms as a physical symptom, such as headaches [ 26 ].…”

“…Experiencing antenatal morbidities may have a significant impact on depressive symptoms [ 20 , 21 ], especially to common antenatal morbidities, such as gestational diabetes (GDM), preeclampsia, headache, nausea, and vomiting [ 22 ]. However, previous studies showed that GDM [ 21 , 23 ], preeclampsia [ 22 , 24 ], headache [ 25 , 26 ], nausea, and vomiting [ 20 , 22 ] are not consistently associated with perinatal depressive symptoms. Moreover, the association between postnatal conditions and postnatal depressive symptoms has been explored, but the results for mode of delivery [ 27 , 28 ], gestation of infant [ 22 , 29 ], and role of newborn gender [ 28 , 30 ] are inconsistent.…”

The Migraine-Anxiety Comorbidity Among Migraineurs: A Systematic Review

“…In all the studies the results demonstrated a strong relationship in terms of Odds Ratios ( 38 ) between anxiety and migraine compared to non-migraineurs. Both the Brazilian studies ( 29 , 39 ) showed exceptionally high ORs (OR = 13 and 25 in order), with the other six studies showing ORs ranging from 1.77 to 4.5 ( 40 , 41 ).…”

Utilization of complementary and alternative medicine and conventional medicine for headache or migraine during pregnancy: A cross-sectional survey of 1,835 pregnant women

“…20 This divergence in reported prevalence rates between seeking help for headache or migraine during pregnancy as opposed to non-pregnancy headache or migraine may be due to headache or migraine being related to serious illness during pregnancy including hypertension, 3 preeclampsia, 4 heart disease, 21 and depression. 22 Women may be more inclined to seek the advice of a healthcare professional if these symptoms occur during pregnancy if they perceive them to be potentially signs of more serious illness that could negatively influence the course of their pregnancy, delivery and the health of their unborn baby. In addition to the fear of complications, this vulnerable group of pregnant women with headache or migraine may also need more information from the practitioners regarding the usability and safety of routinely used treatments in pregnancy.…”