Each year, 18% of women and 6% of males in the U.S. experience migraines, making up roughly 12% of the population overall.
Although there aren’t many substantial prospective studies, case-control and retrospective research has revealed a relationship between migraine and unfavorable pregnancy outcomes.
Aura, the migraine phenomenology most strongly linked to vascular risk, hasn’t been mentioned in earlier prospective research either.
Alexandra Purdue-Smithe, Ph.D., and coworkers examined 30,555 pregnancies among female participants in the Nurses’ Health Research II longitudinal study from 1989 to 2009.
Preterm birth, often known as childbirth before 37 weeks of pregnancy, gestational diabetes, gestational hypertension, preeclampsia, and low birth weight were all evaluated (defined as under 5.5 lb). Multiple pregnancies per woman were accounted for via log-binomial regression.
Women with pre-pregnancy migraine (11%) showed greater risks of preterm birth, gestational hypertension, and preeclampsia than those without pre-pregnancy migraine in models adjusted for age, adiposity, and other behavioral and health factors. Low birth weight or GDM were not linked to prenatal migraine.
Women with migraine with aura had a slightly increased chance of developing preeclampsia than those without pre-pregnancy migraine compared to women without aura.
The risks of other unfavorable pregnancy outcomes were not different by aura phenotype.
Pre-pregnancy migraine was linked to greater odds of preterm delivery, gestational hypertension, and preeclampsia in this sizable prospective investigation. Aura-accompanied migraine was linked to a marginally increased risk of preeclampsia. The management of obstetric risk may include essential considerations of migraine history and phenomenology.
“Our findings suggest that migraine history before the pregnancy portends a heightened risk of preeclampsia and other complications and may be a clinically important factor for physicians to consider when evaluating and managing obstetric risks,” Purdue-Smithe said
The researchers noted that although migraine history was recorded before pregnancy, data regarding migraine aura was not gathered until much later in the trial, when many of the pregnancies had ended.
The study also omitted information on migraine frequency and other characteristics. The risks of other unfavorable pregnancy outcomes were not different by aura phenotype.
Purdue-Smithe presented the findings at the Seattle-based American Academy of Neurology meeting in 2022.