Women with pre-pregnancy migraine have higher risks of pregnancy-related complications: Study
Women who suffer from migraine before they get pregnant have a higher risk of delivering preterm babies, gestational hypertension and pre-eclampsia, researchers of a new study said.
The findings of the study, led by researchers from Brigham And Women's Hospital, the second largest teaching hospital of Harvard Medical School, and published in the journal Neurology recently, the researchers analysed data from thousands of women from the Nurses’ Health Study II to assess the relationship between migraine and pregnancy complications.
The researchers reported that migraine diagnosed before pregnancy was linked to adverse outcomes during pregnancy, including preterm delivery, gestational hypertension, and preeclampsia, suggesting that migraine may be a clinical marker of elevated obstetric risk.
The first author of the study, Dr Alexandra Purdue-Smithe, associate epidemiologist at Brigham and Women's Hospital and instructor in Medicine at Harvard Medical School, stated, "Preterm delivery and hypertensive disorders are some of the primary drivers of maternal and infant morbidity and mortality."
“Our findings suggest that a history of migraine warrants consideration as an important risk factor for these complications and could be useful in flagging women who may benefit from enhanced monitoring during pregnancy,” she added.
Pointing out that women are three times more likely to experience migraine during their lifetime compared to men, the researchers said that migraine is most prevalent among the younger women of the 18-49 age group and about 5.5% of people report aura, sight-related disturbances before the onset of the headache.
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Analysing data from the large, prospective Nurses’ Health Study II, which included 30,555 pregnancies from 19,694 U.S. nurses, Dr Purdue-Smithe and her colleagues looked at pre-pregnancy self-reported physician-diagnosed migraine and migraine phenotype (migraine with and without aura) and incidence of self-reported pregnancy outcomes.
The size of the study population and availability of data on other health and behavioural factors, researchers said that they could control for potential confounding factors such as body mass index, chronic hypertension, and smoking in their analyses.
Researchers found that pre-pregnancy migraine was associated with a 17% higher risk of preterm delivery, a 28% higher rate of gestational hypertension, and a 40% higher preeclampsia rate compared to those with no migraine.
According to the findings, a migraine with aura is associated with a slightly higher risk of preeclampsia than a migraine without aura.
However, they did not find any association between migraine with low birth weight or gestational diabetes.
According to the study, women who took aspirin regularly to treat their migraines had a 45% lower risk of having a preterm baby.
However, noting that migraine is currently not included among indications for aspirin use in pregnancy, Dr Purdue-Smithe said, “Our findings of reduced risk of preterm delivery among women with migraine who reported regular aspirin use before pregnancy suggests that aspirin may also be beneficial for women with migraine.”
“Given the observational nature of our study, and the lack of detailed information on aspirin dosage available in the cohort, clinical trials will be needed to definitively answer this question,” she added.
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