The award from the Society for Pediatric and Perinatal Epidemiologic Research (SPER) was given to Dr Wood for her paper entitled “Prenatal triptan exposure increases externalizing behaviors at three years: results from the Norwegian Mother and Child Cohort Study” and was presented to Dr Wood during the SPER conference in Denver June 15-16 2015. What did she find in her research? We asked Dr Wood to find out.
What are triptan medications?
W: Triptans are medications that you take for a migraine. You take them when you start to feel an attack coming on; they work to reduce the severity of the attack, and sometimes to stop it altogether. The medications cross the placenta and also the blood-brain barrier. This combination - being medications that act on neurons, and could reach the developing fetal brain- is why we are interested in determining whether they have an effect on brain development. This is the first study to look at triptan exposure during pregnancy and behavioral outcomes in children, and we did find an increased risk of externalizing problems in children whose mothers used a triptan at least once during pregnancy.
Why is it important to be able to adjust for exposure and confounding changing over time? Is this a usual problem? Do pregnant women start and stop on the medicines, or take them irregularly?
W: The main reason that I wanted to look at changing exposure and confounding is because migraine itself changes over time. Women with migraine might have one, many, or no migraine attacks during pregnancy. And, just as her triptan use will change over time in response to migraine attacks, her use of other medications will change as well. One of the other findings of this study was that women who use triptan in pregnancy also use many other medications, including several- like antidepressants and paracetamol- that have previously been associated with behavior problems in children. So we knew it would be important to control for these other factors.
How can this model be used in forthcoming research?
W: Aside from the specific example of my paper (triptan medications), we know that women start and stop on medications during pregnancy for many reasons. Also, some medications are meant to be taken intermittently, while others are taken consistently. I hope that by using this method, which hasn’t been used much in the pregnancy medication literature, we will encourage other researchers to think carefully about whether time-varying exposure and confounding are potentially important for the medication they are studying.
PharmaTox congratulate Dr Wood on being chosen to receive this prestigious price, which included the registration fee and travel costs to the SPER conference, as well as $500. The paper is now accepted by Pediatric and Perinatal Epidemiology – the official journal for SPER.