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We hypothesized a priori that elevated youth and\/or maternal internalizing symptoms across childhood would be associated with elevated odds of incident migraine in early adolescence, providing insights into the modifiable mental health contributors to incident migraine.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A community\u2010recruited sample of urban youth (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u20091062, 48% female) living in Alberta, Canada were followed through the AOF prospective cohort study from 2008 to 2023. The study outcome, youth migraine, was ascertained through a validated migraine diagnostic questionnaire, administered to 12\u2010year\u2010old youth. The exposures of interest, anxiety and depressive symptoms in youth and mothers, were derived from multiple timepoints when these symptoms were measured, across youth ages 4\u201312 years. The analysis compared odds of incident migraine in youth with a history of elevated internalizing symptoms, and\/or exposure to elevated maternal symptoms, versus unexposed youth. Covariates accounted for included age, sex, gender and racial identity, household income, and parental migraine status.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The odds of incident migraine, diagnosed at a mean age of 12.9\u2009years (standard deviation [SD] 0.8\u2009years) were increased by ~29% with each additional timepoint when maternal anxiety symptoms were elevated across childhood (adjusted odds ratio [aOR] 1.29 per exposure, 95% confidence interval [CI] 1.02\u20131.64,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.036). Similarly, the odds of incident migraine increased by ~29% with each additional exposure to significant youth depressive symptoms across childhood (aOR 1.29 per exposure, 95% CI 1.03\u20131.61,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.026). Sex did not modify this association.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Findings suggest that maternal anxiety and youth depressive symptoms have an antecedent role in youth migraine risk. Although certain migraine risk factors remain non\u2010modifiable (e.g., genetic inheritance), child and parent mental health symptoms may be alleviated through evidence\u2010based mental health treatments. Future clinical research should explore whether reducing exposure to child and parent mental health symptoms could prevent or delay the development of new migraine cases (\u201cincident migraine\u201d).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/head.70078","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T09:01:41Z","timestamp":1773910901000},"page":"1305-1316","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Maternal and child mental health and incident migraine in adolescence: An \u201cAll Our Families\u201d prospective cohort study"],"prefix":"10.1111","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-3945-8848","authenticated-orcid":false,"given":"Kirsten","family":"Sjonnesen","sequence":"first","affiliation":[{"name":"Department of Community Health Sciences, Cumming School of Medicine University of Calgary  Calgary Alberta 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