Background
Suicide is a leading cause of maternal death globally, and suicide
prevalence rates have been shown to be increased in those with migraine. No
previous study has examined the association between migraine and suicidal
ideation during pregnancy.
Objective
To examine the association between migraine and suicidal ideation
among a cohort of pregnant women.
Methods
A cross-sectional study was conducted among 3,372 pregnant women
attending prenatal care clinics in Lima, Peru. Suicidal ideation and
depression were assessed using the Patient Health Questionnaire-9 (PHQ-9)
scale during early pregnancy. Migraine classification (including migraine
and probable migraine) was based on International Classification of Headache
Disorders (ICHD)-III beta criteria. Multivariable logistic regression
analyses were performed to estimate odd ratios (OR) and 95%
confidence intervals (95%CI).
Results
Suicidal ideation was more common among those with migraine
(25.6%) as compared to those with probable migraine (22.1%,
p<0.001) or non-migraineurs (12.3%, p<0.001). After adjusting
for confounders, including depression, those with migraine or probable
migraine had a 78% increased odds of suicidal ideation
(OR=1.78; 95%CI: 1.46–2.17), as compared with
non-migraineurs. Women with both migraine and depression had a 4.14-fold
increased odds of suicidal ideation (OR=4.14; 95%CI:
3.17–5.42) compared to those with neither condition.
Conclusion
Migraine is associated with increased odds of suicidal ideation in
pregnant women even when controlling for depression. These findings support
the consideration of screening women with comorbid migraine and depression
for suicidal behavior during pregnancy.