Maternal migraine in pregnancy was associated with elevated risks for several adverse pregnancy outcomes in the mother and birth, neonatal, and postnatal neurological outcomes in offspring, according to an article published in Headache.

Researchers examined the association between migraine during pregnancy and the risk for adverse outcomes in the mother and children in a cohort study conducted in Denmark over a period of 8 years. The migraine cohort included pregnant women with a diagnosis of migraine during a hospital encounter between January 1, 1995, and the date of pregnancy end, or with at least 2 outpatient dispensing of a migraine-specific acute or prophylactic medication between January 1, 2004, and the date of pregnancy end. The comparison cohort of women without migraine included age-and-conception-year-matched pregnant women without a hospital diagnosis of migraine since 1977 and without any outpatient dispensing for migraine-specific acute or prophylactic medication since during pregnancy since 2004.

Comparison of pregnancies among women with migraine (n=22,841) and matched pregnancies among women without migraine (n=228,324) found migraine to be associated with increased risk for pregnancy-associated hypertension (adjusted prevalence ratio [aPR] 1.50; 95% CI, 1.39-1.61) and miscarriage (aPR 1.10; 95% CI, 1.05-1.15). Migraine was also associated with increased risk for low birth weight offspring (aPR 1.14; 95% CI, 1.06-1.23), preterm birth (aPR 1.21; 95% CI, 1.13-1.3), and cesarean delivery (aPR 1.20; 95% CI, 1.15-1.25), but not with risk for small for gestational age offspring (aPR 0.94; 95% CI, 0.88-0.99) or birth defects (aPR 1.01; 95% CI, 0.93-1.09).

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Offspring prenatally exposed to maternal migraine had higher risks during the neonatal period for intensive care unit admission (adjusted risk ratio [aRR] 1.22; 95% CI, 1.03-1.45), hospitalization (aRR 1.12; 95% CI, 1.06-1.18), dispensed prescriptions (aRR 1.34; 95% CI, 1.24-1.45), and respiratory distress syndrome (aRR 1.20; 95% CI, 1.02-1.42), but not for death (aRR 0.67; 95% CI, 0.43-1.04). During the postnatal period, maternal migraine was associated with increased risk for febrile seizures (aRR 1.27; 95% CI, 1.03-1.57), but not cerebral palsy (aRR 1.00; 95% CI, 0.51-1.94).

A limitation of this study included the potential misclassification of those diagnosed with migraine outside the hospital and those prescribed over the counter medications. Further, confounding factors such as maternal socioeconomic status and severity of migraine were not accounted for in this study.

Researchers concluded that maternal migraine was “associated with elevated risks [for] several adverse pregnancy outcomes in the mother, and with birth, neonatal, and postnatal neurological outcomes in offspring, including pregnancy-associated hypertension disorders, miscarriage, low birth weight, and preterm birth.”

This study was supported by Amgen Inc. Please refer to the reference for a complete list of authors’ disclosures.

Reference

Skajaa N, Szépligeti SK, Xue F, et al. Pregnancy, birth, neonatal, and postnatal neurological outcomes after pregnancy with migraine [published online May 8, 2019]. Headache. doi: 10.1111/head.13536