Pregnant Migraineurs Face Higher Risk of Obstetric and Postpartum Complications

Pregnant women with migraine are at an increased risk of developing obstetric and postpartum complications compared with unaffected women, according to a study presented at the 7th Congress of the European Academy of Neurology.

Researchers reviewed pregnancy and delivery records from a database of Clahit Health Medical Organization in Israel, and assessed data on demographics, mode of delivery, and medical and obstetric complications in each pregnancy trimester. They also looked at use of medications and repeated medical consultations. The study enrolled 161,574 women who gave birth between 2014 and 2019.

The 8723 women who were diagnosed with migraine experienced a higher risk of obstetric complications and postpartum depression compared with the 152,851 women in the control group. Furthermore, pregnant women with migraine were more likely to be admitted to high-risk departments. This rate was 6% for healthy pregnant women, 6.9% for migraineurs without aura, and 8.7% for those with migraine with aura.

Findings also showed pregnant migraineurs:

• Had greater risk of preeclampsia and stroke
• Were more likely to endure gestational diagnoses of diabetes, hyperlipidemia, and blood clots
• Were more likely to experience depression during their pregnancy and in the postpartum period
• Sought more medical consultations and used more medications during the pregnancy and postpartum periods
• Had a greater risk of cesarean section (20.5% vs 18.1%) and epidural anesthesia (43.6% vs 36.5%) compared with those without migraine, respectively

Authors recommended pregnant women with migraine receive high-risk pregnancy protocol of care during their pregnancy due to their heightened susceptibility to obstetric and medical complications. These patients should also complete neurological follow-ups throughout pregnancy and during their postpartum recovery.

Migraine affects more than 10% of people and is one of the most prevalent neurological disorders worldwide. In addition, women are 3 times more likely to be diagnosed with migraine than men, while menstruation, menopause, and childbirth have been shown to induce hormonal changes that can lead to worsened migraine activity.

Reference

Lev N, and Elefant E. Migraine in pregnancy and postpartum epidemiological and clinical characteristics. Presented at: 7th Congress of the European Academy of Neurology; June 19-22, 2021. Abstract OPR-066.