Headache during pregnancy: Etiologies and applicability of the ICHD-3 criteria
Fecha
2021-04Resumen
Introducción
Debido a la alta prevalencia de cefaleas primarias en la población general joven y la tasa de embarazos en este rango de edad, no sorprende encontrar una alta probabilidad de consultas por dolor de cabeza durante el periodo gestacional.
Objetivos
Determinar etiologías, predictores y utilidad de los criterios ICHD-3 beta para diferenciar cefaleas primarias de las no primarias en mujeres embarazadas en Urgencias.
Pacientes y métodos
Estudio transversal que compara la prevalencia de pacientes que reúnen criterios ICHD-3 beta, síntomas asociados, antecedentes de cefalea y características demográficas entre la cefalea primaria y la no primaria.
Resultados
La cefalea fue responsable de 142 (4,8%) de 2.952 admisiones. La cefalea primaria, la no primaria y la no clasificada fueron del 66,9, 27,4 y 5,6%, respectivamente. La migraña y la cefalea asociada con trastornos hipertensivos fueron las etiologías más frecuentes para los grupos primarios y no primarios: 91,6 y 31,4%, respectivamente. Fueron factores asociados con la cefalea primaria: reunir criterios ICHD-3 beta (OR 23,5; IC 95% 12,5-34,5; p < 0,001), antecedente de migraña (OR 2,85; IC 95% 1,18-5,94; p = 0,013), haber presentado episodios similares (OR 6,4; IC 95% 2,78-14,0; p < 0,001) y fosfenos (OR 4,2; IC 95% 1,5-11,68; p = 0,02). Fueron factores asociados con etiologías no primarias: fiebre (OR 12,8; IC 95% 1,38-119; p = 0,016) y presión arterial media superior a 106,6 (OR 2,6; IC 95% 1,7-3,5; p = 0,03).
Conclusión
Los criterios ICHD-3 beta fueron útiles para diferenciar las cefaleas primarias de las no primarias. Esto también es válido para antecedentes de migraña, episodios similares, fosfenos, fiebre y presión arterial alta.
Abstract
Introduction
Given the high prevalence of primary headache in the young population, and the rate of pregnancy in this age group, it is unsurprising that pregnant women present a high likelihood of consulting due to headache.
Objectives
This study seeks to determine the main aetiologies and predictors of headache and the usefulness of the International Classification of Headache Disorders (third edition-beta; ICHD-3 beta) for differentiating primary from non-primary headaches in pregnant women at the emergency department.
Patients and methods
We performed a cross-sectional study comparing the prevalence of patients meeting the ICHD-3 beta criteria, associated symptoms, history of headache, and demographic features between primary and non-primary headaches.
Results
Headache was responsible for 142 out of 2952 admissions (4.8%). Headache was primary, non-primary, or unclassified in 66.9%, 27.4%, and 5.6% of cases, respectively. Migraine and headache associated with hypertensive disorders were the most frequent aetiologies for primary and non-primary headaches: 91.6% and 31.4% of cases, respectively. The factors associated with primary headache were fulfilling the ICHD-3 beta criteria (OR: 23.5; 95% CI, 12.5–34.5; p < 0.001), history of migraine (OR: 2.85; 95% CI, 1.18–5.94; p = 0.013), history of similar episodes (OR: 6.4; 95% CI, 2.78–14.0; p < 0.001), and description of phosphenes (OR: 4.2; 95% CI, 1.5–11.68; p = 0.02). The factors associated with non-primary headaches were fever (OR: 12.8; 95% CI, 1.38–119; p = 0.016) and mean arterial blood pressure greater than 106.6 (OR: 2.6; 95% CI, 1.7–3.5; p = 0.03).
Conclusion
In our study, the ICHD-3 beta criteria were useful for differentiating primary from non-primary headaches in pregnant women. History of migraine, history of similar episodes, phosphenes, fever, and high arterial blood pressure were also valuable predictors.
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URI
http://repositorio.mederi.com.co/handle/123456789/638https://www.sciencedirect.com/science/article/pii/S2667049621000235
Colecciones
- Investigación clínica [389]