title: 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 1321 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.
authors.affiliation: Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA. Electronic address: oro109@mail.harvard.edu.
authors.forename: Olivia R
authors.initials: OR
authors.lastname: Orta
authors.affiliation: Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA.
authors.forename: Bizu
authors.initials: B
authors.lastname: Gelaye
authors.affiliation: Center for Perinatal Studies, Swedish Medical Center, Seattle, WA, USA.
authors.forename: Chungfang
authors.initials: C
authors.lastname: Qiu
authors.affiliation: School of Sport and Exercise, College of Health, Massey University, Wellington, New Zealand.
authors.forename: Lee
authors.initials: L
authors.lastname: Stoner
authors.affiliation: Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA.
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Williams
mesh_terms: D000328:Adult; D001007:Anxiety / Q000453:epidemiology* / Q000209:etiology*; D001008:Anxiety Disorders / Q000453:epidemiology / Q000209:etiology; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology* / Q000209:etiology*; D003866:Depressive Disorder / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D008423:Maternal Age; D020325:Migraine with Aura / Q000150:complications*; D020326:Migraine without Aura / Q000150:complications*; D015205:Northwestern United States / Q000453:epidemiology; D016017:Odds Ratio; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000209:etiology; D011261:Pregnancy Trimester, First; D013315:Stress, Psychological / Q000453:epidemiology* / Q000209:etiology; D055815:Young Adult
keywords: Anxiety; Depression; Migraine; Pregnancy; Stress