NEW ORLEANS—Infants with a maternal history of migraine are more than twice as likely to have colic than infants without such a history, according to a study presented at the 64th Annual Meeting of the American Academy of Neurology. Evidence suggests that infants with a paternal history of migraine also may be more likely to have colic, but the data for this finding are not conclusive.
“Mothers who have a history of migraine can be counseled that their baby may be at higher risk for colic, which may help them prepare better for that possibility,” Amy Gelfand, MD, told Neurology Reviews. “In addition, when evaluating a child with episodic headaches, pediatricians and neurologists can ask about a history of colic during infancy, and this may help lead them toward a diagnosis of migraine sooner, which would allow the child to receive appropriate treatment sooner.” Dr. Gelfand is a pediatric neurologist at the Headache Center of the University of California at San Francisco.
Surveying Parents’ Migraine History
Dr. Gelfand and colleagues sought to determine whether maternal migraine was associated with an increased prevalence of infant colic, or excessive crying in an otherwise healthy infant. To minimize recall bias, Dr. Gelfand assessed colic when babies were six to eight weeks old, when the condition is at its peak.
The investigators administered a one-page survey to mothers who brought their healthy babies to pediatric clinics for two-month checkups. The survey asked the mothers whether their babies had colic according to the modified Wessel criteria (ie, crying for at least three hours a day, for at least three days a week, and for at least one week).
The researchers also asked the mothers (and fathers, when possible) whether a physician had ever diagnosed them with migraine. Because half of migraineurs have not been diagnosed, the investigators incorporated the ID Migraine screener into the survey.
The ID Migraine screener identifies migraineurs based on their responses to three yes-or-no questions. The study’s primary outcome measure was to compare the prevalence of colic among babies with a maternal history of migraine and among babies without this history.
Study Corroborates Previous Estimates of Colic Prevalence
Dr. Gelfand collected 165 surveys and analyzed 154. The prevalence of colic was 14%, which was consistent with previously published estimates. The prevalence of maternal migraine was 18%. Study participants provided paternal data on about 60% of the surveys, and the prevalence of paternal migraine was 10%.
Approximately 29% of infants with a maternal history of migraine had colic, compared with 11% of infants without this history. Dr. Gelfand found no differences in age or sex distribution between babies with and without colic. The magnitude of the effect size was similar to that observed in two previous retrospective studies of children who developed migraine in childhood.
Dr. Gelfand noted that analyzing maternal migraine history instead of following babies to see whether they develop migraine is a limitation of her study. “Ultimately, we do want to follow the babies out, but that takes about a decade to do,” she said.
“As maternal history of migraine was our standard marker for migraine genetics in the baby, I think these results support the hypothesis that infant colic may be an early-life manifestation of migraine genetics in these so-called childhood periodic syndromes,” she added.
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