Abstract
Background: The prevalence of primary headaches in the pediatric population is shaped by many factors, of which pubertal status may possibly play a substantial role. Epidemiological studies in the pediatric population in the gulf region remain scarce.Aims and objectives: To examine the impact of puberty on the prevalence of primary headache disorders among female schoolchildren in Kuwait.Methods: We conducted a cross-sectional study that included Kuwaiti primary and middle schoolgirls in randomly selected schools located in two governorates in Kuwait during the academic year 2018/2019. Prevalence of headache was assessed using the Headache-Attributed Restriction, Disability, Social Handicap and Impaired Participation (HARDSHIP) questionnaire for children and adolescents. Female students were asked about their menarchal status and whether they attained menarche before or after experiencing headaches.Results: The questionnaire was completed by 669 girls with a mean age of 11.44 ± 2.14 years. The 1-year prevalence of migraine headache disorder among girls was 23.62%, and the lifetime prevalence of any headache was 84.9%, whereas the 1-year prevalence of primary headache disorders was 47.98%. The mean age of girls with headaches was 11.44 ± 2.14 years. With respect to diagnostic criteria, migraine headache was the most frequently reported (23.62%), followed by tension-type headaches (20.93%), chronic headaches (2.99%), and probable medication-overuse headaches (0.45%). Postpubertal females were at significantly higher risk of having primary headaches compared to their prepubertal counterparts (64.26 vs. 34%; p < 0.0001). All types of primary headaches were more significantly prevalent among postpubertal girls compared to those who are prepubertal.Conclusion: Migraine headache is commonly reported among Kuwaiti schoolgirls. Postpubertal females are at higher risk of developing primary headaches compared to prepubertal females. Pubertal transition and female sex hormones may play a significant role in the pathophysiology of headaches, migraines in particular, and further research is therefore needed to investigate the underlying mechanisms.
Highlights
METHODSHeadache is one of the most common disorders in childhood, with an estimated 75% of the pediatric population reporting a significant headache by 15 years of age [1]
The 1-year prevalence of primary headaches was significantly associated with pubertal status among females (P < 0.0001) with more pubertal females (64.26%) reporting a primary headache compared to prepubertal females (34.18%)
All types of primary headaches were more prevalent among pubertal females with migraine (P < 0.0001); tensiontype headaches showing a significant association with pubertal status (P < 0.007)
Summary
METHODSHeadache is one of the most common disorders in childhood, with an estimated 75% of the pediatric population reporting a significant headache by 15 years of age [1]. Rates tend to be similar between boys and girls before 10 years of age; as approaching adolescence, girls are reportedly at higher risk of developing migraines [6]. This sexspecific prevalence suggests a role for sex hormones on the course of primary headaches in both genders [7]. These observations postulate a substantial role for puberty and its associated hormonal transition in increasing an adolescent female’s risk of primary headaches, migraine in particular. Epidemiological studies in the pediatric population in the gulf region remain scarce
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