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Prenatal triptan exposure and parent‐reported early childhood neurodevelopmental outcomes: an application of propensity score calibration to adjust for unmeasured confounding by migraine severity
Author(s) -
Wood Mollie E.,
Frazier Jean A.,
Nordeng Hedvig M. E.,
Lapane Kate L.
Publication year - 2016
Publication title -
pharmacoepidemiology and drug safety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.023
H-Index - 96
eISSN - 1099-1557
pISSN - 1053-8569
DOI - 10.1002/pds.3902
Subject(s) - medicine , triptans , propensity score matching , migraine , confounding , odds ratio , confidence interval , psychomotor learning , temperament , pregnancy , pediatrics , randomized controlled trial , cohort study , psychiatry , cognition , personality , psychology , social psychology , biology , genetics
Purpose Triptan medications are serotonin agonists used to treat migraine, a chronic pain condition highly prevalent in women of reproductive age. Data on the safety of triptans during pregnancy are scant. We sought to quantify the association of prenatal triptan exposure on neurodevelopment in 3‐year‐old children. Methods Using data from the Norwegian Mother and Child Cohort Study, we used propensity score matching to examine associations between prenatal triptan exposure and psychomotor function, communication, and temperament. We used an external validation study to perform propensity calibration to adjust effect estimates for confounders unmeasured in the main study (migraine severity, type, and maternal attitudes towards medication use). Results We identified 4204 women who reported migraine headache at baseline, of which 375 (8.9%) reported using a triptan greater than or equal to once during pregnancy. Children with prenatal triptan exposure had 1.37‐fold greater unadjusted odds of fine motor problems (95% confidence interval (CI): 1.06–1.77), which decreased after propensity score matching (odds ratio (OR): 1.29, 95%CI 0.97–1.73) and was further attenuated after calibration (OR: 1.25, 95%CI 0.89–1.74). We observed no increased risk for gross motor or communication problems, and no differences in temperament. Adjustment for migraine severity using propensity score calibration had a moderate impact on effect estimates, with percent changes ranging from 2.4% to 50%. Conclusions Prenatal triptan exposure was not associated with psychomotor function, communication problems, or temperament in 3‐year‐old children. Adjustment for migraine severity reduced effect estimates and should be considered in future studies of the safety of triptans during pregnancy. Copyright © 2015 John Wiley & Sons, Ltd.