Migraines Can Impact Complications in Birth

Pregnant women who obtain treatment for acute migraine experience higher rates of preeclampsia, preterm delivery, and deliver babies with low birth-weight.

Matthew S. Robbins, MD, associate professor, clinical neurology, Albert Einstein College of Medicine, chief of neurology, Jack D. Weiler Hospital, Montefiore Medical Center, and director of inpatient services, Montefiore Headache Center, Bronx, NY, presented findings at the American Academy of Neurology’s 68^th Annual Meeting in Vancouver, Canada.

The study involved 90 pregnant women with an average age of 29.3 who reported acute migraine and received a neurologic consultation between July 1, 2009 and June 30, 2014.

Experts believed that migraine with aura, the symptoms patients notice before the onset of the headache, “was very over-represented in the sample,” with a report of 40.7% patients.

Upon administration of intravenous and other therapies, findings showed the rate of preeclampsia was 19.5% for the migraine group compared to the national rate of 3-4%. Physicians were also urged to suggest non-medication approaches like relaxation techniques, biofeedback, and trigger avoidance.

Additionally, the team found:

· The preterm delivery rate was 28.2% compared to the national rate of 11.4%

· The rate of birth-weight in infants was 19.2% compared with the national rate of 8.0%

Migraines are fairly common among women considered of childbearing age. While most don’t experience attacks during pregnancy, some do, likely from lack of sleep or stress.

According to Robbins, “Over half the patients experiences some type of adverse birth outcome, which suggests that pregnancies in such patients should be considered high risk, especially in older women.”

Experts also hypothesized, “Women with migraine have a higher rate of cardiovascular complications which may in part be genetic.”

However, having chronic migraine or status migrainous didn’t directly predict adverse pregnancy outcomes.

The team did address that the study was limited to an inner-city population who were overweight and had a history of preeclampsia. Nevertheless, the study “doe suggest that if women have active migraine in pregnancy, maybe they should be followed quite closely during the pregnancy for complications later on.”

Researchers concluded, “The importance of the migraine study is to alert all doctors, especially obstetricians, that history of migraine headaches is a risk factor for preeclampsia. These patients may need to be considered high risk and followed more closely for blood pressure elevations and proteinuria.”