Prenatal Triptan Use for Migraine and Child Neurodevelopment: A Systematic Review
Bibliographic record
Abstract
Objective: Triptans are a class of drugs commonly used as an abortive medication for migraine. They can cross the placental barrier in pregnancy and bind to 5-HT receptors in the fetal brain, possibly affecting brain development. The objective of this systematic review was to summarize and evaluate published literature examining the association between prenatal triptan use for migraine and child neurodevelopment. Methods: Search terms for “pregnancy” and “triptans” were used to search MEDLINE, Embase, and CINAHL for relevant studies published from database inception to August 2023. Original research studies published in English examining the relationship between triptan use for maternal migraine during pregnancy and child neurodevelopment were included. An adapted version of the Systematic Assessment of Quality in Observational Research (SAQOR) protocol was used for the quality assessment of included studies. We also performed a narrative synthesis of eligible studies by describing their methods and main findings. Results: Our search strategy retrieved 1093 articles, of which 5 met the inclusion criteria. All 5 studies used data from the Norwegian Mother and Child Cohort Study (MoBa). Studies selected for review all used parental self-report to measure triptan use and were all rated as moderate quality (n = 5, 100%). Outcome variables varied across studies and included externalizing and internalizing behaviour problems, communication, psychomotor function, temperament, and Attention-Deficit/Hyperactivity Disorder (ADHD). Two studies reported an association between prenatal triptan use and externalizing behaviours in children up to 3 years old, but no associations with other neurodevelopmental outcomes or in older children were reported in the literature. All studies accounted for confounding by indication for migraine, but residual confounding by migraine severity was possible. Discussion: Prenatal triptan exposure may be associated with an increased risk of externalizing behaviours in children aged 1.5-3 years old. Future studies outside of the MoBa cohort are required to test the external validity of findings reported in the current literature. Additionally, future studies can expand the state of knowledge by considering different triptans as separate exposures and by utilizing more robust measures of triptan use in pregnancy that are less subject to recall bias than participant self-report.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.027 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.006 | 0.006 |
| Bibliometrics | 0.008 | 0.009 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".