Maternal migraine may increase risk for adverse pregnancy outcomes
Women with migraine had a higher risk for several adverse outcomes after pregnancy compared with women without migraine, according to results from a Danish population-based cohort study.
“Migraine is a disabling condition, common among women of reproductive age,” Nils Skajaa, BSc, an epidemiologist in the department of clinical epidemiology at Aarhus University Hospital in Denmark, said in a press release. “Accumulating evidence shows that migraine in pregnancy may lead to several adverse outcomes in the mother and child, but treatment may alleviate these risks.”
Researchers used several national registries to collect data on pregnancies with estimated conception dates between Jan 1, 2005, and Dec. 31, 2012. Researchers identified pregnancies in women who had been diagnosed with migraine during a hospital visit between Jan. 1, 1995, and the end of their pregnancy and in women who were dispensed migraine-specific acute or prophylactic medication between Jan. 1, 2004, and the end of their pregnancy. Pregnancies in women without migraine were used as a comparison cohort.
Researchers identified 22,841 pregnancies in women with migraine and 228,324 pregnancies in women without migraine. The median age of women included in the study was 31 years. Pregnancies in women with migraine had a higher prevalence of pregnancy-associated hypertensive disorders (adjusted prevalence ratio [PR] = 1.5; 95% CI, 1.39-1.61), and miscarriage (adjusted PR = 1.1; 95% CI, 1.05-1.15).
Pregnancies in women with migraine were at an increased risk for low birth weight infants (adjusted PR = 1.14; 95% CI, 1.06-1.23), preterm birth (adjusted PR = 1.21; 95% CI, 1.13-1.3) and very preterm birth (adjusted PR = 1.35; 95% CI, 1.14-1.6). Women with migraine were also more likely to have delivery by cesarean section (adjusted PR = 1.2; 95% CI, 1.15-1.25) than women without migraine. Maternal migraine was not associated with birth defects.
Infants prenatally exposed to maternal migraine had a higher prevalence of neonatal ICU admission (adjusted RR = 1.22; 95% CI, 1.03-1.45), hospitalization (adjusted RR = 1.12; 95% CI, 1.06-1.18), and dispensed prescriptions (adjusted RR = 1.34; 95% CI, 1.24-1.45). These infants were also at an increased risk for respiratory distress syndrome (adjusted RR = 1.2; 95% CI, 1.02-1.42) and febrile seizures (adjusted RR = 1.27; 95% CI, 1.03-1.57). Pregnancies in mothers with migraine were not associated with an increased risk for neonatal death.
Pregnancies associated with treated migraine did not have a higher risk of adverse outcomes compared to untreated migraine.
“Our findings suggest that migraine itself, rather than its treatment, is associated with adverse outcomes,” Skajaa and colleagues wrote. – by Erin Michael
Disclosures: Skajaa reports no relevant financial disclosures. Please see study for all other authors’ relevant financial disclosures.